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Jieu B, Sykorova EB, Rohleder C, Marcolini E, Hoffmann AE, Koethe D, Leweke FM, Couttas TA. Alterations to sphingolipid metabolism from antipsychotic administration in healthy volunteers are restored following the use of cannabidiol. Psychiatry Res 2024; 339:116005. [PMID: 38950483 DOI: 10.1016/j.psychres.2024.116005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/06/2024] [Accepted: 06/01/2024] [Indexed: 07/03/2024]
Abstract
Randomized clinical trials substantiate cannabidiol (CBD) as a next-generation antipsychotic, effective in alleviating positive and negative symptoms associated with psychosis, while minimising the adverse effects seen with established treatments. Although the mechanisms remain debated, CBD is known to induce drug-responsive changes in lipid-based retrograde neurotransmitters. Lipid aberrations are also frequently observed with antipsychotics, which may contribute to their efficacy or increase the risk of undesirables, including metabolic dysfunction, obesity and dyslipidaemia. Our study investigated CBD's impact following lipid responses triggered by interaction with second-generation antipsychotics (SGA) in a randomized phase I safety study. Untargeted mass spectrometry assessed the lipidomic profiles of human sera, collected from 38 healthy volunteers. Serum samples were obtained prior to commencement of any medication (t = 0), 3 days after consecutive administration of one of the five, placebo-controlled, treatment arms designed to achieve steady-state concentrations of each SGA (amisulpride, 150 mg/day; quetiapine, 300 mg/day; olanzapine 10 mg/day; risperidone, 3 mg/day), and after six successive days of SGA treatment combined with CBD (800 mg/day). Receiver operating characteristics (ROC) refined 3712 features to a putative list of 15 lipids significantly altered (AUC > 0.7), classified into sphingolipids (53 %), glycerolipids (27 %) and glycerophospholipids (20 %). Targeted mass spectrometry confirmed reduced sphingomyelin and ceramide levels with antipsychotics, which mapped along their catabolic pathway and were restored by CBD. These sphingolipids inversely correlated with body weight after olanzapine, quetiapine, and risperidone treatment, where CBD appears to have arrested or attenuated these effects. Herein, we propose CBD may alleviate aberrant sphingolipid metabolism and that further investigation into sphingolipids as markers for monitoring side effects of SGAs and efficacy of CBD is warranted.
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Affiliation(s)
- Beverly Jieu
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Eliska B Sykorova
- Dept. of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cathrin Rohleder
- Brain and Mind Centre, The University of Sydney, Sydney, Australia; Dept. of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Endosane Pharmaceuticals GmbH, Berlin, Germany
| | - Elisabeth Marcolini
- Dept. of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anna E Hoffmann
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Dagmar Koethe
- Brain and Mind Centre, The University of Sydney, Sydney, Australia; Dept. of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - F Markus Leweke
- Brain and Mind Centre, The University of Sydney, Sydney, Australia; Dept. of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Endosane Pharmaceuticals GmbH, Berlin, Germany
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Bransfield RC, Goud Gadila SK, Kursawe LJ, Dwork AJ, Rosoklija G, Horn EJ, Cook MJ, Embers ME. Late-stage borreliosis and substance abuse. Heliyon 2024; 10:e31159. [PMID: 38779029 PMCID: PMC11108998 DOI: 10.1016/j.heliyon.2024.e31159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Background Infectious diseases can contribute to substance abuse. Here, a fatal case of borreliosis and substance abuse is reported. This patient had a history of multiple tick bites and increasing multisystem symptoms, yet diagnosis and treatment were delayed. He experimented with multiple substances including phencyclidine (PCP), an N-methyl-d-aspartate (NMDA) receptor antagonist that opposes NMDA agonism caused by Borrelia infection. During PCP withdrawal, he committed one homicide, two assaults, and suicide. Methods Brain tissue was obtained from autopsy and stained for microglial activation and quinolinic acid (QA). Immunoflouresence (IFA) and fluorescence in situ hybridization (FISH) were used to identify the presence of pathogens in autopsy tissue. Results Autopsy tissue evaluation demonstrated Borrelia in the pancreas by IFA and heart by IFA and FISH. Activated microglia and QA were found in the brain, indicating neuroinflammation. It is postulated that PCP withdrawal may exacerbate symptoms produced by Borrelia-induced biochemical imbalances in the brain. This combination may have greatly increased his acute homicidal and suicidal risk. Patient databases also demonstrated the risk of homicide or suicide in patients diagnosed with borreliosis and confirmed multiple symptoms in these patients, including chronic pain, anxiety, and anhedonia. Conclusions Late-stage borreliosis is associated with multiple symptoms that may contribute to an increased risk of substance abuse and addictive disorders. More effective diagnosis and treatment of borreliosis, and attention to substance abuse potential may help reduce associated morbidity and mortality in patients with borreliosis, particularly in endemic areas.
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Affiliation(s)
- Robert C. Bransfield
- Rutgers-RWJ Medical School, Piscataway, NJ, USA. Hackensack Meridian Health-School of Medicine, Nutley, NJ, USA
| | - Shiva Kumar Goud Gadila
- Division of Immunology, Tulane National Primate Research Center, Tulane University Health Sciences, Covington, LA, USA
| | - Laura J. Kursawe
- Charité – Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Andrew J. Dwork
- Department of Psychiatry, Columbia University, New York, NY, United States. Division of Molecular Imaging and Neuropathology, New York, USA
- State Psychiatric Institute, New York, NY, USA
- Macedonian Academy of Sciences and Arts, Skopje, Macedonia
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Gorazd Rosoklija
- State Psychiatric Institute, New York, NY, USA
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | | | | | - Monica E. Embers
- Division of Immunology, Tulane National Primate Research Center, Tulane University Health Sciences, Covington, LA, USA
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Wu TY, Tien N, Lin CL, Cheah YC, Hsu CY, Tsai FJ, Fang YJ, Lim YP. Influence of antipsychotic medications on hyperlipidemia risk in patients with schizophrenia: evidence from a population-based cohort study and in vitro hepatic lipid homeostasis gene expression. Front Med (Lausanne) 2023; 10:1137977. [PMID: 37425327 PMCID: PMC10324036 DOI: 10.3389/fmed.2023.1137977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/02/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Schizophrenia increases the risk of mortality and cardiovascular disease (CVD) risk. However, the correlation between antipsychotics (APs) and CVD remains controversial. Hyperlipidemia is a significant risk factor for CVD. Methods We conducted a nationwide population-based retrospective cohort study to investigate the effects of APs on the risk of hyperlipidemia and lipid homeostasis gene expression. We used data from the Longitudinal Health Insurance Database of Taiwan on new-onset schizophrenia patients and a comparison cohort without schizophrenia. We used a Cox proportional hazards regression model to analyze the differences in hyperlipidemia development between the two cohorts. Furthermore, we examined the effects of APs on the hepatic expression of lipid homeostasis-related genes. Results After adjusting for potential interrelated confounding factors, the case group (N = 4,533) was found to have a higher hyperlipidemia risk than the control cohort (N = 4,533) [adjusted hazard ratio (aHR), 1.30, p < 0.001]. Patients with schizophrenia without APs had a significantly higher risk of hyperlipidemia (aHR, 2.16; p < 0.001). However, patients receiving APs had a significantly lower risk of hyperlipidemia than patients not receiving APs (all aHR ≤ 0.42, p < 0.001). First-generation antipsychotics (FGAs) induce the expression of hepatic lipid catabolism genes in an in vitro model. Discussion Patients with schizophrenia had a higher risk of hyperlipidemia than controls; however, compared with non-treated patients, AP users had a lower risk of hyperlipidemia. Early diagnosis and management of hyperlipidemia may help prevent CVD.
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Affiliation(s)
- Tien-Yuan Wu
- Graduate Institute of Clinical Pharmacy, College of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Ni Tien
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Cun Cheah
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
| | - Chung Y. Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Division of Medical Genetics, China Medical University Children's Hospital, Taichung, Taiwan
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
| | - Yi-Jen Fang
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan
- Department of Environmental Health, Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung-Hsing University, Taichung, Taiwan
- Digestive Disease Center, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Yun-Ping Lim
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
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Ma S, Ju P, Xia Q, Pan Z, Gao J, Zhang L, Gao H, Yan J, Zhang J, Wang K, Li C, Xie W, Zhu C. Automatic Thoughts, Self-Stigma, and Resilience Among Schizophrenia Patients with Metabolic Syndrome: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2023; 19:1195-1206. [PMID: 37220563 PMCID: PMC10200106 DOI: 10.2147/ndt.s407662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/28/2023] [Indexed: 05/25/2023] Open
Abstract
Purpose The study aims to clarify the negative psychological state and resilience impairments of schizophrenia (SCZ) with metabolic syndrome (MetS) while evaluating their potential as risk factors. Patients and Methods We recruited 143 individuals and divided them into three groups. Participants were evaluated using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD)-24, Hamilton Anxiety Rating Scale (HAMA)-14, Automatic Thoughts Questionnaire (ATQ), Stigma of Mental Illness scale and Connor-Davidson Resilience Scale (CD-RISC). Serum biochemical parameters were measured by automatic biochemistry analyzer. Results The score of ATQ was highest in the MetS group (F = 14.5, p < 0.001), and the total score of CD-RISC, subscale tenacity score and subscale strength score of CD-RISC were lowest in the MetS group (F = 8.54, p < 0.001; F = 5.79, p = 0.004; F = 10.9, p < 0.001). A stepwise regression analysis demonstrated that a negative correlation was observed among the ATQ with employment status, high-density lipoprotein (HDL-C), and CD-RISC (β=-0.190, t=-2.297, p = 0.023; β=-0.278, t=-3.437, p = 0.001; β=-0.238, t=-2.904, p = 0.004). A positive correlation was observed among the ATQ with waist, TG, WBC, and stigma (β=0.271, t = 3.340, p = 0.001; β=0.283, t = 3.509, p = 0.001; β=0.231, t = 2.815, p = 0.006; β=0.251, t=-2.504, p = 0.014). The area under the receiver-operating characteristic curve analysis showed that among all independent predictors of ATQ, the TG, waist, HDL-C, CD-RISC, and stigma presented excellent specificity at 0.918, 0.852, 0.759, 0.633, and 0.605, respectively. Conclusion Results suggested that the non-MetS and MetS groups had grievous sense of stigma, particularly, high degree of ATQ and resilience impairment was shown by the MetS group. The TG, waist, HDL-C of metabolic parameters, CD-RISC, and stigma presented excellent specificity to predict ATQ, and the waist showed excellent specificity to predict low resilience level.
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Affiliation(s)
- Shenglan Ma
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Peijun Ju
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, People’s Republic of China
| | - Qingrong Xia
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Zhongde Pan
- Shanghai Key Laboratory of Forensic Medicine, Academy of Forensic Science, Shanghai, People’s Republic of China
| | - Jianliang Gao
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Loufeng Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Hua Gao
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Junwei Yan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Jie Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Keming Wang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Chao Li
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Wen Xie
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Cuizhen Zhu
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
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Yan H, Huang Z, Lu Y, Qiu Y, Li M, Li J. Associations between metabolic disorders and sleep disturbance in patients with schizophrenia. Compr Psychiatry 2023; 122:152369. [PMID: 36702060 DOI: 10.1016/j.comppsych.2023.152369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Sleep disturbance plays a crucial role in mental illness and metabolic dysregulation. However, the clinical correlates of metabolic disorders (MD, only meeting 1 or 2 metabolic syndrome standards) and its relationship to sleep disturbance in patients with schizophrenia are uncertain. The study was to illuminate the association between MD and sleep disturbance in patients with schizophrenia. METHODS One hundred and sixty-four patients with schizophrenia (157 drug-naive and 7 drug-free) were classified into 2 groups: MD and non-MD. The Pittsburgh Sleep Quality Index (PSQI) and the Positive and Negative Symptom Scale (PANSS) were employed to assess sleep quality and clinical symptoms. Weight, height, waistline, blood pressure, fasting glucose, and lipid metabolic levels were recorded. RESULTS Sleep disturbance was more pronounced in the MD group compared to the non-MD group, including subjective sleep quality (z = -4.074, p = 0.000), sleep latency (z = -3.867, p = 0.000), sleep duration (z = -2.471, p = 0.013) and total scores (z = -3.074, p = 0.002). After controlling for confounding factors including age, sex, body mass index, smoking, marital status, and duration of illness, binary logistics regression showed that subjective sleep quality (p = 0.034) and sleep latency (p = 0.034) were significant independent predictors of MD. Further, partial correlation analysis showed that sleep latency (r = -0.200, p = 0.011) was significantly negatively correlated with HDLC. CONCLUSION Our study suggests a high rate of MD in patients with schizophrenia, most of who were drug-naive, in a Chinese population. Longer sleep latency is associated with MD in schizophrenia patients, suggesting an important role of sleep disturbance in the development of MD in patients with schizophrenia. Interventions to improve sleep quality may prevent MD in patients with schizophrenia at an early stage.
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Affiliation(s)
- Huiming Yan
- Laboratory of Biological Psychiatry,Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Rd., Hexi District, Tianjin 300222, China
| | - Zhenni Huang
- Laboratory of Biological Psychiatry,Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Rd., Hexi District, Tianjin 300222, China
| | - Yao Lu
- Institute of Applied Psychology, Tianjin University, 135 Yaguan Road, Jinnan District, Tianjin 300350, China.
| | - Yuying Qiu
- Laboratory of Biological Psychiatry,Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Rd., Hexi District, Tianjin 300222, China
| | - Meijuan Li
- Laboratory of Biological Psychiatry,Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Rd., Hexi District, Tianjin 300222, China
| | - Jie Li
- Laboratory of Biological Psychiatry,Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Rd., Hexi District, Tianjin 300222, China; Institute of Applied Psychology, Tianjin University, 135 Yaguan Road, Jinnan District, Tianjin 300350, China.
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Borkent J, Ioannou M, Folkertsma TS, Wardenaar KJ, Haarman BCM, van Goor H, Sommer IEC, Bourgonje AR. Serum free thiols in recently diagnosed patients with schizophrenia spectrum disorder: A potentially useful biomarker of oxidative stress. Psychiatry Res 2023; 321:115075. [PMID: 36764120 DOI: 10.1016/j.psychres.2023.115075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/13/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
Schizophrenia spectrum disorders (SSD) have been linked to oxidative stress (OS). Recent findings from our group show that serum free thiols (R-SH, sulfhydryl groups) can function as an accurate biomarker of systemic OS, since they are readily oxidized by reactive species (ROS), thereby serving as potent antioxidants. The aim of this study is to investigate if reduced R-SH levels can be demonstrated in recently diagnosed patients with SSD compared to healthy controls (HC). In this study, 102 patients with recently diagnosed SSD (< three years), and 42 HC were included. Levels of R-SH were quantified and studied for correlations with age, C-reactive protein (CRP) as proxy of inflammation as well as body mass index (BMI) and total cholesterol as indices of metabolic health. R-SH levels were significantly lower in patients when compared to HC. When correcting for age the difference was borderline significant (p=0.05). Moreover, R-SH correlated significantly with age (r = -0.29) and CRP (r = -0.29) in patients with SSD, but not in the HC. R-SH levels are reduced in SSD as compared to HC and correlate negatively with CRP and age in SSD. Future studies are required to further investigate R-SH and its role in SSD.
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Affiliation(s)
- Jenny Borkent
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands.
| | - Magdalini Ioannou
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Tessa S Folkertsma
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Bartholomeus C M Haarman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Iris E C Sommer
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands
| | - Arno R Bourgonje
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Liu J, Fu L. Metabolic syndrome in patients with schizophrenia: Why should we care. Medicine (Baltimore) 2022; 101:e29775. [PMID: 35960125 PMCID: PMC9371547 DOI: 10.1097/md.0000000000029775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Metabolic syndrome (MS) is a serious disease in patients with schizophrenia; it is necessary to evaluate the characteristics and influencing factors of MS to provide reliable evidence for the management of schizophrenia. Patients with schizophrenia treated in our hospital from January 1, 2018, to March 31, 2021, were selected. The characteristics and treatment details of MS and no-MS patients were evaluated. Pearson correlation analyses were applied for analyzing MS and related characteristics. Logistic regression analyses were conducted to evaluate the risk factors of MS in patients with schizophrenia. A total of 465 patients with schizophrenia were included, the incidence of MS in patients with schizophrenia was 18.06%. Pearson correlation analyses had found that age (r = 0.621), waist circumference (r = 0.744), body mass index (r = 0.691), diabetes (r = 0.598), course of disease (r = 0.504), triglyceride (r = 0.532), high-density lipoprotein cholesterol (r = -0.518), low-density lipoprotein cholesterol (r = 0.447), and total cholesterol (r = 0.523) were correlated with MS (all P < .05). Logistic regression analyses showed that age ≥55 years (odds ratio [OR]: 2.012, 95% confidence interval [CI]: 1.425-3.196), waist circumference ≥80 cm (OR: 1.944, 95% CI: 1.081-3.172), body mass index ≥24.5 kg/m2 (OR: 2.451, 95% CI: 1.825-3.108), diabetes (OR: 2.301, 95% CI: 1.944-2.881), course of disease ≥15 years (OR: 1.804, 95% CI: 1.236-2.845), triglyceride ≥1.5 mmol/L (OR: 2.032, 95% CI: 1.614-3.079), high-density lipoprotein cholesterol ≤0.8 mmol/L (OR: 1.226, 95% CI: 1.102-1.845), low-density lipoprotein cholesterol ≥2 mmol/L (OR: 1.759, 95% CI: 1.236-1.987), and total cholesterol ≥4.5 mmol/L (OR: 1.664, 95% CI: 1.422-1.852) were the risk factors of MS in patients with schizophrenia (all P < .05). MS is very common in patients with schizophrenia, which may be associated with many possible risk factors, and early interventions and nursing care targeted at those influencing factors are needed to improve the prognosis of schizophrenia.
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Affiliation(s)
- Jichao Liu
- Department of Psychiatry, Tianjin Anding Hospital, Hexi District, Tianjin, China
| | - Lijuan Fu
- Department of Psychiatry, Tianjin Anding Hospital, Hexi District, Tianjin, China
- *Correspondence: Lijuan Fu, Department of Psychiatry, Tianjin Anding Hospital, No. 13, Liulin Road, Hexi District, Tianjin, China (e-mail: )
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Mahmood D, Alenezi SK, Anwar MJ, Azam F, Qureshi KA, Jaremko M. New Paradigms of Old Psychedelics in Schizophrenia. Pharmaceuticals (Basel) 2022; 15:ph15050640. [PMID: 35631466 PMCID: PMC9147282 DOI: 10.3390/ph15050640] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/08/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Psychedelics such as lysergic acid diethylamide (LSD), psilocybin (magic mushrooms), and mescaline exhibit intense effects on the human brain and behaviour. In recent years, there has been a surge in studies investigating these drugs because clinical studies have shown that these once banned drugs are well tolerated and efficacious in medically supervised low doses called microdosing. Psychedelics have demonstrated efficacy in treating neuropsychiatric maladies such as difficult to treat anxiety, depression, mood disorders, obsessive compulsive disorders, suicidal ideation, posttraumatic stress disorder, and also in treating substance use disorders. The primary mode of action of psychedelics is activation of serotonin 5-HT2A receptors affecting cognition and brain connectivity through the modulation of several downstream signalling pathways via complex molecular mechanisms. Some atypical antipsychotic drugs (APDs) primarily exhibit pharmacological actions through 5-HT2A receptors, which are also the target of psychedelic drugs. Psychedelic drugs including the newer second generation along with the glutamatergic APDs are thought to mediate pharmacological actions through a common pathway, i.e., a complex serotonin-glutamate receptor interaction in cortical neurons of pyramidal origin. Furthermore, psychedelic drugs have been reported to act via a complex interplay between 5HT2A, mGlu2/3, and NMDA receptors to mediate neurobehavioral and pharmacological actions. Findings from recent studies have suggested that serotoninergic and glutamatergic neurotransmissions are very closely connected in producing pharmacological responses to psychedelics and antipsychotic medication. Emerging hypotheses suggest that psychedelics work through brain resetting mechanisms. Hence, there is a need to dig deeply into psychedelic neurobiology to uncover how psychedelics could best be used as scientific tools to benefit psychiatric disorders including schizophrenia.
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Affiliation(s)
- Danish Mahmood
- Department of Pharmacology & Toxicology, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia; (S.K.A.); (M.J.A.)
- Correspondence: or
| | - Sattam K. Alenezi
- Department of Pharmacology & Toxicology, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia; (S.K.A.); (M.J.A.)
| | - Md. Jamir Anwar
- Department of Pharmacology & Toxicology, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia; (S.K.A.); (M.J.A.)
| | - Faizul Azam
- Department of Pharmaceutical Chemistry & Pharmacognosy, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia;
| | - Kamal A. Qureshi
- Department of Pharmaceutics, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia;
| | - Mariusz Jaremko
- Smart-Health Initiative (SHI) and Red Sea Research Center (RSRC), Division of Biological and Environmental Sciences and Engineering (BESE), King Abdullah University of Science and Technology (KAUST), Thuwal 23955, Saudi Arabia;
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Schizophrenia Outside the Brain. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1400:53-63. [DOI: 10.1007/978-3-030-97182-3_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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10
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Iannuzzo F, Basile GA, Campolo D, Genovese G, Pandolfo G, Giunta L, Ruggeri D, Di Benedetto A, Bruno A. Metabolic and clinical effect of alpha-lipoic acid administration in schizophrenic subjects stabilized with atypical antipsychotics: A 12-week, open-label, uncontrolled study. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2022; 3:100116. [PMID: 35992380 PMCID: PMC9389248 DOI: 10.1016/j.crphar.2022.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Many of the atypical antipsychotics induce metabolic side effects, limiting their use in clinical practice. Alpha-lipoic acid (ALA) was proposed as a new approach in schizophrenia to improve metabolic effects of atypical antipsychotics. The aim of the study is to evaluate the effect of ALA on metabolic and clinical parameters among schizophrenic subjects. Methods 15 schizophrenic subjects, in stable atypical antipsychotic monotherapy were included in the study. ALA was administrated at the oral daily dose of 600 mg/d in addition to antipsychotic therapy. Metabolic, clinical, and psychopathological parameters were measured at typical antipsychotics. e initial screening, and after 12 weeks. Results ALA produced a statistically significant reduction in QTc (p = 0.012), blood glucose (p = 0.005), AST (p = 0.021), γGT (p = 0.035), CPK (p = 0.005) and prolactinaemia (p = 0.026). In contrast, there was a significant increase in HbA1c (p = 0.026). No effects on body weight and blood lipid levels (triglycerides, total cholesterol, HDL, LDL) emerged. Conclusions ALA treatment appeared to be effective for reducing diabetes risk, liver functionality parameters, hyperprolactinaemia and QTC interval. ALA appears to be safe as adjunctive components in schizophrenia. Atypical antipsychotics induce the frequent occurrence of metabolic side effects. Prevalence rates of Metabolic Syndrome in patients with schizophrenia are high. No specific therapies for metabolic effects of SGAs in schizophrenia are still available. ALA was suggested as a potential therapeutic agent in various chronic diseases. ALA appeared to be effective to improve metabolic values in schizophrenia.
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Affiliation(s)
- Fiammetta Iannuzzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina, 98125, Italy
- Corresponding author. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, Via Consolare Valeria, 1, 98125, Messina, Italy.
| | - Gianpaolo Antonio Basile
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina, 98125, Italy
| | - Domenica Campolo
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Giovanni Genovese
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Gianluca Pandolfo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina, 98125, Italy
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Loretta Giunta
- Department of Internal Medicine, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Domenica Ruggeri
- Department of Internal Medicine, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Antonino Di Benedetto
- Department of Internal Medicine, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina, 98125, Italy
- Psychiatry Unit, Polyclinic Hospital University of Messina, Via Consolare Valeria 1, Contesse, 98125, Messina, Italy
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Metabolic Syndrome and Dietary Habits in Hospitalized Patients with Schizophrenia: A Cross-Sectional Study. MEDICINA-LITHUANIA 2021; 57:medicina57030255. [PMID: 33801842 PMCID: PMC8001284 DOI: 10.3390/medicina57030255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The true prevalence of metabolic syndrome (MetS) and the reason for it being higher in patients with schizophrenia when compared to general population have not yet been fully determined. Although being considered as one of the major causes, currently there are limited findings regarding differences in dietary patterns of schizophrenic patients with and without MetS. The present study aimed to determine the prevalence of MetS among hospitalized patients with schizophrenia, to investigate the differences in socio-demographic, clinical, and lifestyle characteristics between participants with and without MetS, with the special emphasis being put on their dietary habits, and to ascertain the correlation between dietary habits and MetS components. Materials and Methods: A cross-sectional study included 259 hospitalized patients with schizophrenia aged ≥ 18 years. All participants underwent basic anthropometric measurements, blood sampling and blood pressure assessment, and provided relevant socio-demographic and lifestyle information. The presence of MetS was determined according to the Joint Interim Statement definition and dietary habits were assessed using a non-quantitative food frequency questionnaire. Results: The overall prevalence of MetS was 47.9%. No socio-demographic or lifestyle differences were found between participants with and without MetS. A large number of participants (42.9%) reported consuming carbonated soft drinks on a daily basis. Daily frequency of fruit (11.6%) and vegetables intake (29.3%) was far below recommended. Dietary habits of participants with and without MetS did not significantly differ, while consumption frequencies of some of the studied food and beverage items and groups significantly correlated with certain MetS components (such as statistically significant positive correlation between cured meat products consumption frequency and waist circumference, as well as between red meat consumption frequency and systolic blood pressure). Conclusions: The concept of the present study did not allow us to distinguish to what extent the participants’ dietary habits were influenced by independent procurement of food products, nor has it allowed us to quantify the portion sizes of consumed food and beverage items and groups. Nevertheless, the findings indicate the need for early identification of individuals with high MetS risk and for the incorporation of nutritional support programs into hospital treatment of patients with schizophrenia.
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12
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Paderina DZ, Boiko AS, Pozhidaev IV, Bocharova AV, Mednova IA, Fedorenko OY, Kornetova EG, Loonen AJ, Semke AV, Bokhan NA, Ivanova SA. Genetic Polymorphisms of 5-HT Receptors and Antipsychotic-Induced Metabolic Dysfunction in Patients with Schizophrenia. J Pers Med 2021; 11:jpm11030181. [PMID: 33807811 PMCID: PMC7999828 DOI: 10.3390/jpm11030181] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Antipsychotic-induced metabolic syndrome (MetS) is a multifactorial disease with a genetic predisposition. Serotonin and its receptors are involved in antipsychotic-drug-induced metabolic disorders. The present study investigated the association of nine polymorphisms in the four 5-hydroxytryptamine receptor (HTR) genes HTR1A, HTR2A, HTR3A, and HTR2C and the gene encoding for the serotonin transporter SLC6A4 with MetS in patients with schizophrenia. METHODS A set of nine single-nucleotide polymorphisms of genes of the serotonergic system was investigated in a population of 475 patients from several Siberian regions (Russia) with a clinical diagnosis of schizophrenia. Genotyping was performed and the results were analyzed using chi-square tests. RESULTS Polymorphic variant rs521018 (HTR2C) was associated with higher body mass index in patients receiving long-term antipsychotic therapy, but not with drug-induced metabolic syndrome. Rs1150226 (HTR3A) was also associated but did not meet Hardy-Weinberg equilibrium. CONCLUSIONS Our results indicate that allelic variants of HTR2C genes may have consequences on metabolic parameters. MetS may have too complex a mechanistic background to be studied without dissecting the syndrome into its individual (causal) components.
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Affiliation(s)
- Diana Z. Paderina
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
| | - Anastasiia S. Boiko
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
| | - Ivan V. Pozhidaev
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
| | - Anna V. Bocharova
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634050 Tomsk, Russia;
| | - Irina A. Mednova
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
| | - Olga Yu. Fedorenko
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
| | - Elena G. Kornetova
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
- Siberian State Medical University, 634050 Tomsk, Russia
| | - Anton J.M. Loonen
- Unit of PharmacoTherapy, -Epidemiology & -Economics, Groningen Research Institute of Pharmacy, University of Groningen, 9713AV Groningen, The Netherlands
- Correspondence:
| | - Arkadiy V. Semke
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
| | - Nikolay A. Bokhan
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
- Siberian State Medical University, 634050 Tomsk, Russia
| | - Svetlana A. Ivanova
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia; (D.Z.P.); (A.S.B.); (I.V.P.); (I.A.M.); (O.Y.F.); (E.G.K.); (A.V.S.); (N.A.B.); (S.A.I.)
- Siberian State Medical University, 634050 Tomsk, Russia
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Liao X, Ye H, Si T. A Review of Switching Strategies for Patients with Schizophrenia Comorbid with Metabolic Syndrome or Metabolic Abnormalities. Neuropsychiatr Dis Treat 2021; 17:453-469. [PMID: 33603382 PMCID: PMC7884949 DOI: 10.2147/ndt.s294521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/07/2021] [Indexed: 12/31/2022] Open
Abstract
Metabolic syndrome (MetS) in patients with schizophrenia occurs 2-3 times more frequently than in the general population. Antipsychotic medication is a primary risk factor for patients with MetS. In particular, the widely used second-generation antipsychotics can affect glucose and lipid metabolism and can induce insulin resistance and other metabolic abnormalities through various receptors. Notably, the metabolic risks of various antipsychotics may differ because of their different pharmacological affinity to MetS-related receptors. Several previous studies have shown that switching from high to low metabolic risk antipsychotics may improve patients' metabolic parameters. The current review aims to discuss the strategies for switching antipsychotic medications and the impact on metabolic abnormalities in patients with schizophrenia.
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Affiliation(s)
- Xuemei Liao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, People's Republic of China
| | - Hui Ye
- Medical Department, Sanofi, Shanghai, People's Republic of China
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, People's Republic of China
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Jahrami H, Altooq N, Aburowais S, Alajaimi A, Albanna I, Alhaj O. Low-carbohydrate diet improves the cardiopsychiatry profile of patients with schizophrenia: A pilot study. HEART AND MIND 2021. [DOI: 10.4103/hm.hm_25_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Muruganandam P, Neelamegam S, Menon V, Alexander J, Chaturvedi SK. COVID-19 and Severe Mental Illness: Impact on patients and its relation with their awareness about COVID-19. Psychiatry Res 2020; 291:113265. [PMID: 32763536 PMCID: PMC7322460 DOI: 10.1016/j.psychres.2020.113265] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 02/08/2023]
Abstract
COVID-19 outbreak has promoted many public health measures in the general population. However, its impact on a vulnerable population with severe mental illness (SMI) is less addressed. Aim of this study was to determine the impact of COVID -19 to patients with SMI and identify its relation with their COVID-19 knowledge. A cross-sectional telephonic survey among 132 patients with SMI who were clinically stable before the COVID-19 pandemic was conducted. A 23 item interview proforma comprising of self-reported knowledge related to COVID-19 by patients and their illness and treatment status from their caregivers. Eleven patients were completely not aware of the ongoing COVID-19 pandemic. Three fourth of patients were not worried about getting COVID-19 and lacks adequate knowledge to identify symptoms. Two-third of patients lacked adequate knowledge of precautionary measures against COVID-19. One out of five patients lacked knowledge of the mode of transmission and stopped their psychiatric treatment. Thirty percent showed features of relapse of symptoms during this lockdown period. In multivariate regression analysis, patients from lower socioeconomic status, low literacy levels, with inadequate social support showed less knowledge related to COVID-19. Mental health services which target this vulnerable population during early disaster reduce the burden to the community.
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Affiliation(s)
- Partheeban Muruganandam
- Department of Psychiatry, Aaarupadai Veedu Medical College & Hospital, Puducherry-607402, India.
| | - Srinivasan Neelamegam
- Department of Psychiatry, Aaarupadai Veedu Medical College & Hospital, Puducherry-607402, India
| | - Vikas Menon
- Department Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry-605006, India
| | - Johndinesh Alexander
- Department of Psychiatry, Aaarupadai Veedu Medical College & Hospital, Puducherry-607402, India
| | - Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore-560029, India
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Yoca G, Anıl Yağcıoğlu AE, Eni N, Karahan S, Türkoğlu İ, Akal Yıldız E, Mercanlıgil SM, Yazıcı MK. A follow-up study of metabolic syndrome in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2020; 270:611-618. [PMID: 31030256 DOI: 10.1007/s00406-019-01016-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
Abstract
The prevalence of metabolic syndrome (MetS) in schizophrenia patients is increasing worldwide. The aim of the current study was to examine the progress of MetS in a schizophrenia cohort we had previously investigated and determine the role of various related factors, including sociodemographic and clinical variables, nutritional status and physical activity. Of the 319 patients investigated in the first study, 149 patients agreed to be included in the follow-up. Physical measurements and laboratory tests were performed in addition to evaluations with the Positive and Negative Syndrome Scale, Udvalg for Kliniske Undersogelser Side Effects Scale, International Physical Activity Questionnaire, 24 h dietary recall method and Nutrition Information Systems Package Program. According to the ATPIII, ATPIIIA and IDF criteria, the MetS prevalences had increased from 35.6 to 44.3%, 38.9 to 53% and 43.6 to 55.7%, respectively. Patients with MetS had a shorter period of hospitalization and a higher UKU total side effects score, and most of them were married or divorced/widowed. Patients with MetS also had a higher daily consumption of added sugar, cholesterol, polyunsaturated fatty acids and omega 3 fatty acid, and the daily added sugar intake was found to be related to the increase in MetS. Unexpectedly, the physical activity level was not found to significantly differ in the patients with and without MetS. In conclusion, the MetS prevalence was found to be increased among schizophrenia patients over time, and the increase in the young age group was particularly striking. Among all of the factors investigated, nutritional status was found to play a major role in this increased prevalence.
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Affiliation(s)
- Gökhan Yoca
- Department of Psychiatry, Şarkışla State Hospital, Sivas, Turkey
| | - A Elif Anıl Yağcıoğlu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, 06100, Turkey
| | - Nurhayat Eni
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, 06100, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İnci Türkoğlu
- Department of Nutrition and Dietetics, Hacettepe University Faculty of Health Sciences, Ankara, Turkey
| | - Emine Akal Yıldız
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Eastern Mediterranean University, T.R. North Cyprus via Mersin 10, Famagusta, Turkey
| | - Seyit M Mercanlıgil
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Cyprus International University, T.R. North Cyprus via Mersin 10, Nicosia, Turkey
| | - M Kâzım Yazıcı
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, 06100, Turkey.
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Habtewold TD, Islam MA, Liemburg EJ, Bruggeman R, Alizadeh BZ. Polygenic risk score for schizophrenia was not associated with glycemic level (HbA1c) in patients with non-affective psychosis: Genetic Risk and Outcome of Psychosis (GROUP) cohort study. J Psychosom Res 2020; 132:109968. [PMID: 32169752 DOI: 10.1016/j.jpsychores.2020.109968] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Type 2 diabetes (T2D) is a common comorbidity in patients with schizophrenia (SCZ). The underlying pathophysiologic mechanisms are yet to be fully elucidated, although it can be argued that shared genes, environmental factors or their interaction effect are involved. This study investigated the association between polygenic risk score of SCZ (PRSSCZ) and glycated haemoglobin (HbA1c) while adjusting for polygenic risk score of T2D (PRST2D), and clinical and demographic covariables. METHODS Genotype, clinical and demographic data of 1129 patients with non-affective psychosis were extracted from Genetic Risk and Outcome of Psychosis (GROUP) cohort study. The glycated haemoglobin (HbA1c) was the outcome. PRS was calculated using standard methods. Univariable and multivariable linear regression analyses were applied to estimate associations. Additionally, sensitivity analysis based on multiple imputation was done. After correction for multiple testing, a two-sided p-value ≤.003 was considered to discover evidence for an association. RESULTS Of 1129 patients, 75.8% were male with median age of 29 years. The mean (standard deviation) HbA1c level was 35.1 (5.9) mmol/mol. There was no evidence for an association between high HbA1c level and increased PRSSCZ (adjusted regression coefficient (aβ) = 0.69, standard error (SE) = 0.77, p-value = .37). On the other hand, there was evidence for an association between high HbA1c level and increased PRST2D (aβ = 0.93, SE = 0.32, p-value = .004), body mass index (aβ = 0.20, SE = 0.08, p-value = .01), diastolic blood pressure (aβ = 0.08, SE = 0.04, p-value = .03), late age of first psychosis onset (aβ = 0.19, SE = 0.05, p-value = .0004) and male gender (aβ = 1.58, SE = 0.81, p-value = .05). After multiple testing correction, there was evidence for an association between high HbA1c level and late age of first psychosis onset. Evidence for interaction effect between PRSscz and antipsychotics was not observed. The multiple imputation-based sensitivity analysis provided consistent results with complete case analysis. CONCLUSIONS Glycemic dysregulation in patients with SCZ was not associated with PRSSCZ. This suggests that the mechanisms of hyperglycemia or diabetes are at least partly independent from genetic predisposition to SCZ. Our findings show that the change in HbA1c level can be caused by at least in part due to PRST2D, late age of illness onset, male gender, and increased body mass index and diastolic blood pressure.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands.
| | - Md Atiqul Islam
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; Shahjalal University of Science and Technology, Department of Statistics, Sylhet, Bangladesh
| | - Edith J Liemburg
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands; University of Groningen, Department of Clinical and Developmental Neuropsychology, Groningen, the Netherlands.
| | - Behrooz Z Alizadeh
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
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Almonte MT, Capellàn P, Yap TE, Cordeiro MF. Retinal correlates of psychiatric disorders. Ther Adv Chronic Dis 2020; 11:2040622320905215. [PMID: 32215197 PMCID: PMC7065291 DOI: 10.1177/2040622320905215] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/08/2020] [Indexed: 12/27/2022] Open
Abstract
Diagnosis and monitoring of psychiatric disorders rely heavily on subjective self-reports of clinical symptoms, which are complicated by the varying consistency of accounts reported by patients with an impaired mental state. Hence, more objective and quantifiable measures have been sought to provide clinicians with more robust methods to evaluate symptomology and track progression of disease in response to treatments. Owing to the shared origins of the retina and the brain, it has been suggested that changes in the retina may correlate with structural and functional changes in the brain. Vast improvements in retinal imaging, namely optical coherence tomography (OCT) and electrodiagnostic technology, have made it possible to investigate the eye at a microscopic level, allowing for the investigation of potential biomarkers in vivo. This review provides a summary of retinal biomarkers associated with schizophrenia, bipolar disorder and major depression, demonstrating how retinal biomarkers may be used to complement existing methods and provide structural markers of pathophysiological mechanisms that underpin brain dysfunction in psychiatric disorders.
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Affiliation(s)
- Melanie T. Almonte
- Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | | | - Timothy E. Yap
- Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
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The Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Metabolic Syndrome in Hospitalized Schizophrenic Patients: A Randomized Controlled Trial. Nutrients 2019; 11:nu11122950. [PMID: 31817080 PMCID: PMC6950694 DOI: 10.3390/nu11122950] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 11/27/2019] [Accepted: 12/02/2019] [Indexed: 02/07/2023] Open
Abstract
The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and metabolic syndrome (MetS) in people with schizophrenia is unknown and remains to be investigated. Therefore, we have conducted a three-month parallel-group randomized controlled trial. Sixty-seven hospitalized schizophrenic patients with MetS [n = 33 in the intervention group (IG) and n = 34 in the control group (CG)] completed the intervention. The IG followed the DASH diet with the caloric restriction of approximately 1673.6 kJ/day (400 kcal/day) when compared to the standard hospital diet followed by the CG. Simultaneously, both groups participated in a nutrition counseling program. Anthropometric and biochemical parameters and blood pressure were measured at the baseline and after three months, while nutrient intakes during the intervention were assessed using three non-consecutive 24-hour dietary recalls. The analyses were carried out based on the per-protocol approach. At three months, the MetS prevalence significantly decreased in both the IG and the CG (75.8%, p = 0.002, and 67.7%, p = 0.0003, respectively; odds ratio = 0.9; 95% confidence interval = 0.43–1.87). No significant differences in the prevalence of MetS and its features were found between the groups.
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Merces MCD, Gomes AMT, Coelho JMF, Servo MLS, Marques SC, D’Oliveira Júnior A. Evidências científicas sobre a associação entre burnout e síndrome metabólica: revisão integrativa. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar as evidências científicas disponíveis na literatura sobre a associação entre Síndrome de Burnout e Síndrome Metabólica. Métodos Revisão integrativa da literatura, com buscas nas bases de dados do Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online e Springer Link. Os artigos selecionados foram analisados de acordo com a Agency for Healthcare Research and Quality. Resultados A maioria (80%) dos 5 artigos que atenderam aos critérios de seleção estava na língua inglesa e indexada nas bases de dados Web of Science e Scopus. Dentre os trabalhos, 80% tinham médicos como autores principais. O continente asiático (Israel, Japão e China) concentrou a maior parte de produção. Não ocorreu predominância de desenho de estudo. A área financeira correspondeu a 60% do público pesquisado. Conclusão As evidências disponíveis na literatura são incipientes, apenas 20% dos artigos elegíveis apresentou associação entre as síndromes estudadas e os demais, indicam associação entre Burnout e componentes da SM separadamente.
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Grover S, R P, Sahoo S, Gopal S, Nehra R, Ganesh A, Raghavan V, Sankaranarayan A. Relationship of metabolic syndrome and neurocognitive deficits in patients with schizophrenia. Psychiatry Res 2019; 278:56-64. [PMID: 31146142 DOI: 10.1016/j.psychres.2019.05.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 01/23/2023]
Abstract
This study aimed to evaluate the association of the metabolic syndrome (MS) and its components with neurocognition among patients with schizophrenia. 121 patients with schizophrenia from an outpatient service of two psychiatric centers were assessed on a neurocognitive battery and by metabolic measures. More than half (56.2%) of the patients fulfilled the consensus criteria for MS. After controlling/adjusting for various covariates (age, education in years, duration of illness, age of onset, Positive and Negative Symptom scale score and presence of smoking status), it was found that compared to patients without MS, those with MS had significantly poorer performance "in the cognitive domains" of cognitive processing and selective attention (Stroop effect percentile; p value 0.002; effect size-0.45) and auditory and verbal memory (AVLT; p value <0.001; effect size 0.68). Patients with a higher number of abnormal parameters of MS had poorer functioning in the domains of cognitive processing and selective attention, auditory and verbal memory, and executive tasks. To conclude, this two center study suggests that MS has a negative impact on neurocognition in patients with schizophrenia. There is a need to identify and monitor metabolic abnormalities among patients with schizophrenia to minimize the negative effect of metabolic parameters on neurocognition.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
| | - Padmavati R
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
| | | | - Ritu Nehra
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
| | - Arthi Ganesh
- Schizophrenia Research Foundation (SCARF), Chennai, India
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Tay YH, Lee J. The relationship between serum adiponectin levels, cardiometabolic indices and metabolic syndrome in schizophrenia. Asian J Psychiatr 2019; 43:1-6. [PMID: 31059867 DOI: 10.1016/j.ajp.2019.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/05/2019] [Accepted: 04/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Adiponectin is a hormone secreted by adipose tissues that is thought to influence lipid and glucose metabolism, and the development of metabolic derangements, including metabolic syndrome (MetS), in schizophrenia. We aim to determine the serum adiponectin levels in Chinese patients with schizophrenia, and explore the relationship between adiponectin levels and metabolic parameters, including MetS and its components. We hypothesized that serum adiponectin levels are similar in schizophrenia patients and controls, but decreased amongst patients on atypical antipsychotics. METHODS 81 patients and 81 controls were recruited. Anthropometric parameters and fasted blood samples for metabolic measurements were obtained. Serum adiponectin levels were measured using Bioplex assays. RESULTS There was no difference in median adiponectin levels between schizophrenia patients and controls. Those taking typical antipsychotics alone had lower median adiponectin levels than those on mixed typical and atypical antipsychotics. Serum adiponectin level, controlled for age, gender and body mass index, was positively correlated with high-density lipoprotein cholesterol, and negatively correlated with diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels in schizophrenia patients. Patients with MetS had lower median adiponectin levels than those without MetS, and serum adiponectin levels decreased as the number of MetS components increased. After adjusting for variables thought to influence MetS, our logistic regression model did not reveal any significant association between adiponectin levels and MetS in schizophrenia patients. CONCLUSION Our findings highlight the need for more studies focusing on serum adiponectin level and its relationship with MetS in schizophrenia, particularly in those taking typical antipsychotics.
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Affiliation(s)
- Yi Hang Tay
- Department of Forensic Psychiatry, Institute of Mental Health, Singapore.
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore; North Region & Department of Psychosis, Institute of Mental Health, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Skibinska M, Kapelski P, Rajewska-Rager A, Szczepankiewicz A, Narozna B, Duda J, Dmitrzak-Weglarz M, Twarowska-Hauser J, Pawlak J. Correlation of metabolic parameters, neurotrophin-3, and neurotrophin-4 serum levels in women with schizophrenia and first-onset depression. Nord J Psychiatry 2019; 73:96-103. [PMID: 30654674 DOI: 10.1080/08039488.2018.1563213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Neurotrophin-3 (NTF3) and neurotrophin-4 (NTF4) play a crucial role in the neurodevelopment, differentiation, survival, and protection of neurons in different brain regions. Schizophrenia and depression are highly associated with metabolic abnormalities. Longitudinal and cross-sectional comparisons of NTF3 and NTF4 levels, as well as clinical and metabolic parameters, were studied in schizophrenia, first-episode depression, and control groups. MATERIALS AND METHODS Serum NTF3 and NTF4 levels, body mass index (BMI), fasting serum glucose and lipid profile: cholesterol, triglyceride, high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) were measured at baseline and week 8 in 133 women: 55 patients with schizophrenia (19 with first-episode and 36 chronic), 30 patients with a first-episode depression and 48 healthy controls. The severity of the symptoms was evaluated with the Positive and Negative Syndrome Scale, 17-item Hamilton Depression Rating Scale and the Beck Depression Inventory. RESULTS Longitudinal and cross-sectional comparisons did not detect any differences in the serum levels of NTF3 and NTF4 between studied groups. NTF3 and NTF4 levels were strongly correlated. Correlation of NTF3 and HDL-C levels at baseline was observed. Significant changes in cholesterol and fasting serum glucose levels in first-episode depression patients during 8 weeks of treatment were detected. Significant differences in BMI and LDL-C levels between schizophrenia and first-episode depression patients were discovered. CONCLUSIONS To our knowledge, this is the first research which correlates NTF3 and NTF4 with metabolic parameters. Our study does not support the theory that the peripheral levels of NTF3 and NTF4 are disturbed in schizophrenia or first-episode depression.
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Affiliation(s)
- Maria Skibinska
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Pawel Kapelski
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Aleksandra Rajewska-Rager
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Aleksandra Szczepankiewicz
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Beata Narozna
- b Laboratory of Molecular and Cell Biology , Poznan University of Medical Sciences , Poznan , Poland
| | - Joanna Duda
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Monika Dmitrzak-Weglarz
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Joanna Twarowska-Hauser
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Joanna Pawlak
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
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Anjum S, Bathla M. A comparative study of prevalence and predictors of metabolic syndrome in various psychiatric disorders in state of Haryana: More than 30 years Vs. less than 30 years. Diabetes Metab Syndr 2019; 13:510-516. [PMID: 30641756 DOI: 10.1016/j.dsx.2018.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/02/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Exponential growth of metabolic syndrome in psychiatric disorders is becoming alarming situation to handle with. It is associated with reduced life span of 10-30 years in psychiatric patients attributed to metabolic syndrome, thus needs to be screened and addressed in all psychiatric patients. OBJECTIVE the objective of this study was to know the prevalence and its risk factors in various psychiatric disorder and comparing them in older vs younger patients. METHODOLOGY A cross sectional indoor based study was conducted after taking ethical committee approval in 140 patients (substance use disorder, schizophrenia, bipolar and depressive disorders). All the metabolic parameters as per International diabetes federation criteria for metabolic syndrome were assessed involving waist circumference, weight, height, Systolic/diastolic blood pressure, fasting blood sugar, high density lipoprotein and triglycerides. STATISTICS Chi square and t-test were used. RESULTS It was seen that prevalence of metabolic syndrome (MS); 21.4% in psychiatric illness, up to 40% in major depressive disorders, followed by 33% in substance use disorder and 26.7% in psychotic disorders. Prevalence of MS was higher in older patients >30 years group (26% Vs. 16.4% in <30 years group). It was observed that substance use and depressive disorder and high BP in older male patients are all the significant risk factors for metabolic syndrome. CONCLUSION More than 1/5th psychiatric patients are affected by metabolic syndrome. Thus, all male psychiatric patients with high BP must be evaluated for metabolic syndrome.
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Affiliation(s)
- Shazia Anjum
- MM Institute of Medical Sciences and Research, Mullana, Ambala, India
| | - Manish Bathla
- MM Institute of Medical Sciences and Research, Mullana, Ambala, India.
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Skibinska M, Kapelski P, Rajewska-Rager A, Szczepankiewicz A, Narozna B, Duda J, Budzinski B, Twarowska-Hauser J, Dmitrzak-Weglarz M, Pawlak J. Elevated brain-derived neurotrophic factor (BDNF) serum levels in an acute episode of schizophrenia in polish women: Correlation with clinical and metabolic parameters. Psychiatry Res 2019; 271:89-95. [PMID: 30472511 DOI: 10.1016/j.psychres.2018.11.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/31/2018] [Accepted: 11/18/2018] [Indexed: 12/21/2022]
Abstract
Brain-derived neurotrophic factor (BDNF) has been implicated in the pathogenesis of psychiatric disorders. Schizophrenia is associated with metabolic abnormalities and BDNF regulates energy homeostasis and glucose metabolism in peripheral tissues. The aim of this study was to examine serum levels of BDNF in schizophrenic women during 8 weeks of treatment and control group, and its correlation with clinical and metabolic parameters. The study was performed on a group of 96 women: 55 diagnosed with paranoid schizophrenia according to DSM-IV criteria, and 41 healthy controls. Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of schizophrenia. BDNF serum levels and metabolic parameters: fasting serum glucose, total cholesterol, triglyceride (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) were measured at baseline and week 8 of treatment. BDNF serum levels were significantly elevated in medicated patients with schizophrenia comparing to controls. After 8 weeks of antipsychotic treatment, BDNF levels did not significantly change. Increase in TG and TG/HDL-C ratio and a decrease in HDL-C was detected in medicated patients. Correlation between BDNF and lipid profile as well as symptoms severity was found. In our study we detected abnormalities in BDNF levels and lipid profile in medicated schizophrenic women in Polish population.
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Affiliation(s)
- Maria Skibinska
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
| | - Pawel Kapelski
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Rajewska-Rager
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Szczepankiewicz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Beata Narozna
- Laboratory of Molecular and Cell Biology, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572, Poznan, Poland
| | - Joanna Duda
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartłomiej Budzinski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572, Poznan, Poland
| | - Joanna Twarowska-Hauser
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Pawlak
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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Rohatgi R, Gupta R, Ray R, Kalra V. Is obstructive sleep apnea the missing link between metabolic syndrome and second-generation antipsychotics: Preliminary study. Indian J Psychiatry 2018; 60:478-484. [PMID: 30581214 PMCID: PMC6278225 DOI: 10.4103/psychiatry.indianjpsychiatry_105_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Metabolic syndrome in individuals taking second-generation antipsychotics is thought to be mediated by antipsychotic-induced weight gain. However, recent literature challenges this notion, and theoretically, it may also be mediated through obstructive sleep apnea (OSA). This study explores the contribution of OSA in antipsychotic-induced metabolic syndrome. MATERIALS AND METHODS Forty-three participants suffering from schizophrenia spectrum disorder and major depressive disorder, taking second-generation antipsychotics were included in this study. Treatment history was taken in detail, and lifetime exposure to antipsychotics was converted to olanzapine-equivalent doses. Physical characteristics were noted. OSA was screened through the Hindi version of Berlin Questionnaire. Plasma glucose, serum total cholesterol, serum high-density lipoprotein, and serum triglyceride were measured after 12-h fasting. Adult treatment Panel-III criteria were used to diagnose metabolic syndrome. RESULTS Gender distribution was comparable in the study sample. About 27% had continuous illness, 25.6% of participants had metabolic syndrome, and 20.9% were at high risk for sleep apnea. Participants with and without metabolic syndrome were comparable with regard to demographic variables, duration of illness, and lifetime exposure to antipsychotics. Logistic regression depicted that OSA (odds ratio [OR] = 15.09), waist circumference (OR = 1.15), and fasting plasma glucose (OR = 1.21) increased the risk of metabolic syndrome. CONCLUSION Results of the present study suggest that metabolic syndrome in participants taking second-generation antipsychotics is mediated through OSA.
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Affiliation(s)
- Rupali Rohatgi
- Department of Psychiatry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Ravi Gupta
- Department of Psychiatry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Rajat Ray
- Department of Psychiatry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Vinita Kalra
- Department of Biochemistry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Severi E, Ferrara M, Tedeschini E, Vacca F, Mungai F, Amendolara R, Baccari F, Starace F. Assessment of cardiovascular risk in an Italian psychiatric outpatient sample: A chart review of patients treated with second-generation antipsychotics. Int J Ment Health Nurs 2018; 27:1002-1008. [PMID: 29197134 DOI: 10.1111/inm.12407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2017] [Indexed: 12/22/2022]
Abstract
Despite the call by the scientific community for a systematic monitoring of physical health in people with psychiatric illnesses, national and international audits have reported poor quality of cardiovascular risk assessments and management in this vulnerable population. Available evidence indicates that in people affected by mental illness, life expectancy is reduced by 10-20 years, mainly due to cardiovascular accidents and metabolic syndrome (MetS)-related diseases. The primary aim of the present study was to evaluate the accuracy of cardiovascular risk monitoring in an outpatient sample of patients taking second-generation antipsychotics. The sample consisted of 200 patients consecutively recruited from two community mental health centres. A clinical chart review was performed on the following laboratory tests: total cholesterol, high- and low-density lipoprotein, serum triglycerides, fasting blood glucose, γ-glutamyl transpeptidase. Blood pressure and waist circumference were measured. A complete cardiovascular risk assessment was available only in 60 patients out of 200 (33.3%). The only variable associated with laboratory tests for MetS was receiving three or more psychotropic medications, which increased fourfold the probability of metabolic screening. In the subsample of patients with full screening, the prevalence of MetS was 33.3%. Our findings suggest that mental health professionals working in community mental health services should incorporate a more systematic assessment of physical health in their practice, and intervene proactively to reduce the significant cardiovascular burden carried by people with several mental illness.
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Affiliation(s)
- Elena Severi
- Department of Mental Health and Drug Abuse, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Maria Ferrara
- Department of Mental Health and Drug Abuse, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Enrico Tedeschini
- Department of Mental Health and Drug Abuse, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Francesca Vacca
- Department of Mental Health and Drug Abuse, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Francesco Mungai
- Department of Mental Health and Drug Abuse, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Rocco Amendolara
- Department of Mental Health and Drug Abuse, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Flavia Baccari
- Department of Mental Health and Drug Abuse, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Fabrizio Starace
- Department of Mental Health and Drug Abuse, Azienda Unità Sanitaria Locale Modena, Modena, Italy
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Li R, Ou J, Li L, Yang Y, Zhao J, Wu R. The Wnt Signaling Pathway Effector TCF7L2 Mediates Olanzapine-Induced Weight Gain and Insulin Resistance. Front Pharmacol 2018; 9:379. [PMID: 29713286 PMCID: PMC5911481 DOI: 10.3389/fphar.2018.00379] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 04/03/2018] [Indexed: 12/30/2022] Open
Abstract
Olanzapine is a widely used atypical antipsychotic medication for treatment of schizophrenia and is often associated with serious metabolic abnormalities including weight gain and impaired glucose tolerance. These metabolic side effects are severe clinical problems but the underpinning mechanism remains poorly understood. Recently, growing evidence suggests that Wnt signaling pathway has a critical role in the pathogenesis of schizophrenia and molecular cascades of antipsychotics action, of which Wnt signaling pathway key effector TCF7L2 is strongly associated with glucose homeostasis. In this study, we aim to explore the characteristics of metabolic disturbance induced by olanzapine and to elucidate the role of TCF7L2 in this process. C57BL/6 mice were subject to olanzapine (4 mg/kg/day), or olanzapine plus metformin (150 mg/kg/day), or saline, respectively, for 8 weeks. Metabolic indices and TCF7L2 expression levels in liver, skeletal muscle, adipose, and pancreatic tissues were closely monitored. Olanzapine challenge induced remarkably increased body weight, fasting insulin, homeostasis model assessment-insulin resistance index, and TCF7L2 protein expression in liver, skeletal muscle, and adipose tissues. Notably, these effects could be effectively ameliorated by metformin. In addition, we found that olanzapine-induced body weight gain and insulin resistance actively influence the expression of TCF7L2 in liver and skeletal muscle, and elevated level of insulin determines the increased expression of TCF7L2 in adipose tissue. Our results demonstrate that TCF7L2 participates in olanzapine-induced metabolic disturbance, which presents a novel mechanism for olanzapine-induced metabolic disturbance and a potential therapeutic target to prevent the associated metabolic side effects.
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Affiliation(s)
- Ranran Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jianjun Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ye Yang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Renrong Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Shanghai Institute for Biological Science, Chinese Academy of Sciences, Shanghai, China
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Sattar H, Li H, Han Y, Zhou H, Darbalaei S, Li W. Association Between First Episode Schizophrenia, Metabolic Syndrome and Insulin Resistance-Related Proteins in Female Balb/C Mice. Galen Med J 2018; 7:e692. [PMID: 34466413 PMCID: PMC8343899 DOI: 10.22086/gmj.v0i0.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 08/24/2016] [Accepted: 09/02/2016] [Indexed: 11/30/2022] Open
Abstract
Background Metabolic syndrome is a group of different disorders mainly includes, insulin resistance, obesity, cerebrovascular disorders, dyslipidemia, which leads to increase mortality. Patients suffering from related psychotic disorders such as schizophrenia are at the higher risk of developing metabolic syndrome. The aim of this study was to evaluate the association between the first episode of schizophrenia, metabolic syndrome and insulin resistance-related proteins in blood and adipose tissue of mice. Materials and Methods Twelve, female Balb/c mice were randomly divided into two groups; one group was injected intraperitoneal MK-801(0.6mg/kg/d) to induce schizophrenia, and other group received the 0.9% normal saline for two weeks. Body weight, fasting blood glucose (FBG), oral glucose tolerance (OGT), and Homeostatic model assessment (HOMA), were observed. Blood and adipose tissue were collected and Western blotting was done to evaluate the insulin resistance related proteins (GGPPS, FAT, PTP-1B, GRK2, ATGL, FGF21, and PGC-1α) by using GAPDH as an internal standard. Results There was a significant increase in mean body weight in schizophrenic group (21.76 vs 22.81, P=004). On day 14, the FBG, insulin concentrations and Homeostatic model assessment and insulin resistance (HOME-IR) were high in schizhphrenic group vs control group, e.g. 5.3±0.6 vs 3.47±0.2 (P=0.0001), 28.9±2.2 vs 23.3±0.6 (P<0.005) and 9.2±1.3 vs 3.9±0.2 (P=0.0001) . Impaired glucose tolerance deranged from 4.8mmol/L to 6.4mmol/L. Western blotting showed a marked increase in the expression of GGPPS, FAT, ATGL, and FGF21 proteins in monocytes and PTP-1B, GRK2, and PGC-1α ratios in adipose tissues. Conclusion There was a positive relation between schizophrenia and metabolic syndrome e.g. insulin resistance and obesity. Certain proteins in adipocytes and blood were responsible for causing insulin resistance.
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Affiliation(s)
- Haseeb Sattar
- Department of Clinical Pharmacy, Wuhan Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huqun Li
- Department of Clinical Pharmacy, Wuhan Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Han
- Department of Clinical Pharmacy, Wuhan Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Zhou
- Department of Clinical Pharmacy, Wuhan Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sanaz Darbalaei
- Department of Clinical Pharmacy, Wuhan Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiyong Li
- Department of Clinical Pharmacy, Wuhan Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Skibinska M, Kapelski P, Rajewska-Rager A, Pawlak J, Szczepankiewicz A, Narozna B, Twarowska-Hauser J, Dmitrzak-Weglarz M. Brain-derived neurotrophic factor (BDNF) serum level in women with first-episode depression, correlation with clinical and metabolic parameters. Nord J Psychiatry 2018; 72:191-196. [PMID: 29235396 DOI: 10.1080/08039488.2017.1415373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) influences neuron differentiation during development, as well as the synaptic plasticity and neuron survival in adulthood. BDNF has been implicated in the pathogenesis of psychiatric disorders and its serum level is a potential biomarker for depression. The aim of this study was to examine serum levels of BDNF in first-episode depression and its correlation with clinical and metabolic parameters. MATERIALS AND METHODS The study was performed on a group of 60 women: 30 diagnosed with a first-episode of depression and 30 healthy controls. 17-Item Hamilton Depression Rating Scale (HDRS-17) was used to assess the severity of depression. Patients were randomly chosen for treatment with sertraline or venlafaxine. BDNF serum levels and metabolic parameters: fasting serum glucose, cholesterol, triglyceride (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) were measured at baseline and week 8 of treatment. RESULTS There were no differences between BDNF level in depressed patients compared with the healthy controls. Lack of differences in medication effect of sertraline or venlafaxine on HDRS-17 scores during 8 weeks of treatment was observed. Correlation of BDNF at baseline and fasting serum glucose at baseline and week 8 was detected. CONCLUSIONS Correlations of BDNF serum levels with metabolic parameters were observed.
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Affiliation(s)
- Maria Skibinska
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Pawel Kapelski
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | | | - Joanna Pawlak
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Aleksandra Szczepankiewicz
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland.,c Laboratory of Molecular and Cell Biology , Poznan University of Medical Sciences , Poznan , Poland
| | - Beata Narozna
- c Laboratory of Molecular and Cell Biology , Poznan University of Medical Sciences , Poznan , Poland
| | - Joanna Twarowska-Hauser
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
| | - Monika Dmitrzak-Weglarz
- a Psychiatric Genetics Unit, Department of Psychiatry , Poznan University of Medical Sciences , Poznan , Poland
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Anjum S, Bathla M, Panchal S, Singh GP, Singh M. Metabolic syndrome in drug naïve schizophrenic patients. Diabetes Metab Syndr 2018; 12:135-140. [PMID: 29191416 DOI: 10.1016/j.dsx.2017.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 11/22/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Research in the last decade tried to focus on natural and unnatural causes of death in schizophrenic patients, but recent few years has focussed on emerging cardio-metabolic risk factors, as a cause of mortality in such patients. AIM OF THE STUDY To assess the determinant of metabolic syndrome in drug naïve schizophrenic patients. METHODOLOGY It was a cross sectional study; 30 indoor patients with diagnosis of schizophrenia were included. Height, weight, waist circumference and Blood pressure assessment was done by using standard protocol. Fasting Blood Glucose (FBG), Triglyceride (TGs), High Density Lipoprotein (HDL) cholesterol, Low Density Lipoprotein (LDL) total cholesterol were measured. International Diabetes Federation (IDF) criteria was considered for establishing metabolic syndrome. Statistical analysis was done by using chi square and ANOVA. RESULTS Majority of the patients were females; hailing from rural area; unskilled professional; educated up to below primary level; were single and Hindu by religion. Most common metabolic abnormality was low HDL in 76.6%; High TGs in 26.6%; High SBP ≥130mm Hg in 16.67%; DBP>85mm Hg in 13.33%; High FBS 10% of the patients. In risk assessment strongest risk factors for metabolic syndrome were high waist circumference, FBS and TGs. BMI, total cholesterol, LDL and VLDL were also observed as a risk factors in drug naïve schizophrenic patients. CONCLUSION HDL, FBS, TGs, waist circumference and BMI are all the strong risk factors for development of metabolic syndrome in drug naïve schizophrenia patients.
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Affiliation(s)
- Shazia Anjum
- Department of Psychiatry, MM University, Mullana, Ambala, India
| | - Manish Bathla
- Department of Psychiatry, MM University, Mullana, Ambala, India.
| | | | | | - Manpreet Singh
- Department of Psychiatry, MM University, Mullana, Ambala, India
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Huang M, Yu L, Pan F, Lu S, Hu S, Hu J, Chen J, Jin P, Qi H, Xu Y. A randomized, 13-week study assessing the efficacy and metabolic effects of paliperidone palmitate injection and olanzapine in first-episode schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:122-130. [PMID: 29097257 DOI: 10.1016/j.pnpbp.2017.10.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 10/12/2017] [Accepted: 10/30/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND This study was conducted to evaluate the efficacy and metabolic effects of paliperidone palmitate (PP) injections against oral olanzapine in first-episode schizophrenia (FES) patients. METHODS Eligible patients were randomized to receive PP or olanzapine. Efficacy assessments and weight-related parameters were assessed at baseline, weeks 1, 5, 9, and endpoint or at early withdrawal. Lipid, glucose, insulin and prolactin were evaluated at baseline and endpoint or at early withdrawal. RESULTS The Positive And Negative Syndrome Scale (PANSS) scores declined significantly after treatment in both groups. Significant increases in weight-related parameters from baseline to endpoint were shown in both groups. Although there was no significant difference in PANSS scores and weight-related parameters between the two groups through the whole 13-week study. The increased level of triglyceride and HOMA-IR at endpoint from baseline in the olanzapine group was higher than the PP group. There was a stronger elevation of prolactin level in the PP group. CONCLUSIONS In summary, PP and olanzapine showed similar improvement in the treatment of FES patients. This study also reinforced the necessity for regular monitoring of metabolic parameters in schizophrenia patients prescribed atypical antipsychotics. Clinical trial registration numbers: ChiCTR-IOR-14005304. Date of registration: 2014-10-11.
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Affiliation(s)
- Manli Huang
- Department of Mental Health, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou 310003, China
| | - Liang Yu
- Department of Anesthesiology and Pain, Hang Zhou First People's Hospital, No. 261, Huansha Road, Hangzhou 310006, China
| | - Fen Pan
- Department of Mental Health, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou 310003, China
| | - Shaojia Lu
- Department of Mental Health, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou 310003, China
| | - Shaohua Hu
- Department of Mental Health, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou 310003, China
| | - Jianbo Hu
- Department of Mental Health, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou 310003, China
| | - Jinkai Chen
- Department of Mental Health, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou 310003, China
| | - Pingbo Jin
- College of Medcine, Zhejiang University, No. 268, Kaixuan Road, Hangzhou 310000, China
| | - Hongli Qi
- Department of Mental Health, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou 310003, China
| | - Yi Xu
- Department of Mental Health, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder Management of Zhejiang Province, No. 79, Qingchun Road, Hangzhou 310003, China.
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Frank E, Maier D, Pajula J, Suvitaival T, Borgan F, Butz-Ostendorf M, Fischer A, Hietala J, Howes O, Hyötyläinen T, Janssen J, Laurikainen H, Moreno C, Suvisaari J, Van Gils M, Orešič M. Platform for systems medicine research and diagnostic applications in psychotic disorders-The METSY project. Eur Psychiatry 2018; 50:40-46. [PMID: 29361398 DOI: 10.1016/j.eurpsy.2017.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 12/12/2022] Open
Abstract
Psychotic disorders are associated with metabolic abnormalities including alterations in glucose and lipid metabolism. A major challenge in the treatment of psychosis is to identify patients with vulnerable metabolic profiles who may be at risk of developing cardiometabolic co-morbidities. It is established that both central and peripheral metabolic organs use lipids to control energy balance and regulate peripheral insulin sensitivity. The endocannabinoid system, implicated in the regulation of glucose and lipid metabolism, has been shown to be dysregulated in psychosis. It is currently unclear how these endocannabinoid abnormalities relate to metabolic changes in psychosis. Here we review recent research in the field of metabolic co-morbidities in psychotic disorders as well as the methods to study them and potential links to the endocannabinoid system. We also describe the bioinformatics platforms developed in the EU project METSY for the investigations of the biological etiology in patients at risk of psychosis and in first episode psychosis patients. The METSY project was established with the aim to identify and evaluate multi-modal peripheral and neuroimaging markers that may be able to predict the onset and prognosis of psychiatric and metabolic symptoms in patients at risk of developing psychosis and first episode psychosis patients. Given the intrinsic complexity and widespread role of lipid metabolism, a systems biology approach which combines molecular, structural and functional neuroimaging methods with detailed metabolic characterisation and multi-variate network analysis is essential in order to identify how lipid dysregulation may contribute to psychotic disorders. A decision support system, integrating clinical, neuropsychological and neuroimaging data, was also developed in order to aid clinical decision making in psychosis. Knowledge of common and specific mechanisms may aid the etiopathogenic understanding of psychotic and metabolic disorders, facilitate early disease detection, aid treatment selection and elucidate new targets for pharmacological treatments.
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Affiliation(s)
| | | | - Juha Pajula
- VTT Technical Research Centre of Finland Ltd., FI-33720 Tampere, Finland
| | | | - Faith Borgan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London WC2R 2LS, UK; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London W12 0HS, UK
| | | | | | - Jarmo Hietala
- Department of Psychiatry, University of Turku, FI-20520 Turku, Finland; Turku PET Centre, Turku University Hospital, FI-20521 Turku, Finland
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London WC2R 2LS, UK; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London W12 0HS, UK
| | | | - Joost Janssen
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Heikki Laurikainen
- Department of Psychiatry, University of Turku, FI-20520 Turku, Finland; Turku PET Centre, Turku University Hospital, FI-20521 Turku, Finland
| | - Carmen Moreno
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Jaana Suvisaari
- National Institute for Health and Welfare (THL), FI-00300 Helsinki, Finland
| | - Mark Van Gils
- VTT Technical Research Centre of Finland Ltd., FI-33720 Tampere, Finland
| | - Matej Orešič
- Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, FI-20520 Turku, Finland; School of Medical Sciences, Örebro University, 702 81 Örebro, Sweden.
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Bosia M, Buonocore M, Bechi M, Santarelli L, Spangaro M, Cocchi F, Guglielmino C, Bianchi L, Bringheli S, Bosinelli F, Cavallaro R. Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome. Front Psychiatry 2018; 9:647. [PMID: 30581395 PMCID: PMC6293025 DOI: 10.3389/fpsyt.2018.00647] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/16/2018] [Indexed: 11/18/2022] Open
Abstract
Cognitive impairment, typically more severe in treatment resistant patients, is considered a hallmark of schizophrenia and the prime driver of functional disability. Recent evidence suggests that metabolic syndrome may contribute to cognitive deficits in schizophrenia, possibly through shared underlying mechanisms. However, results are still contradictory and no study has so far examined the influence of metabolic syndrome on cognitive outcome after cognitive remediation therapy (CRT). Based on these premises, this study aims to investigate the relationship between metabolic syndrome and cognition, specifically considering cognitive outcome after treatment. Secondary objectives include the analysis of the association between cognitive impairment and psychopathological status and, in a subgroup of patients, the evaluation of the effect of Sterol Regulatory Element Binding Transcription Factor 1 (SREBF-1) rs11868035 genetic polymorphism, previously associated with metabolic alterations, on both cognition and metabolic syndrome. One-hundred seventy-two outpatients with schizophrenia were assessed for metabolic parameters and neurocognitive measures and 138 patients, who completed CRT, were re-evaluated for cognition. A subsample of 51 patients was also genotyped for rs11868035 from peripheral blood sample. Results show a negative impact of metabolic syndrome on executive functions and global cognitive outcome after CRT. Data also revealed a significant effect of SREBF-1 polymorphism, with a higher prevalence of metabolic syndrome and worse processing speed performance among G/G homozygous subjects, compared the A allele carriers. Overall these findings support the hypothesis that metabolic alterations may hamper the capacity to restore cognitive deficits, as well as they highlight the need to further explore possible converging mechanisms underlying both cognitive and metabolic dysfunction. At the clinical level, results point to the importance of a comprehensive assessment including the metabolic status of patients and of individualized strategies addressing metabolic dysfunction in order to potentiate treatment outcome in schizophrenia.
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Affiliation(s)
- Marta Bosia
- School of Medicine, Università Vita-Salute San Raffaele, Milan, Italy.,Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mariachiara Buonocore
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Santarelli
- School of Medicine, Università Vita-Salute San Raffaele, Milan, Italy
| | - Marco Spangaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Cocchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carmelo Guglielmino
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Bianchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Serena Bringheli
- School of Psychology, Università Vita-Salute San Raffaele, Milan, Italy
| | | | - Roberto Cavallaro
- School of Medicine, Università Vita-Salute San Raffaele, Milan, Italy.,Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Pillinger T, Beck K, Stubbs B, Howes OD. Cholesterol and triglyceride levels in first-episode psychosis: systematic review and meta-analysis. Br J Psychiatry 2017; 211:339-349. [PMID: 28982658 PMCID: PMC5709673 DOI: 10.1192/bjp.bp.117.200907] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/14/2017] [Accepted: 08/21/2017] [Indexed: 12/13/2022]
Abstract
BackgroundThe extent of metabolic and lipid changes in first-episode psychosis (FEP) is unclear.AimsTo investigate whether individuals with FEP and no or minimal antipsychotic exposure show lipid and adipocytokine abnormalities compared with healthy controls.MethodWe conducted a meta-analysis of studies examining lipid and adipocytokine parameters in individuals with FEP and no or minimal antipsychotic exposure v. a healthy control group. Studies reported fasting total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and leptin levels.ResultsOf 2070 citations retrieved, 20 case-control studies met inclusion criteria including 1167 patients and 1184 controls. Total cholesterol and LDL cholesterol levels were significantly decreased in patients v. controls, corresponding to an absolute reduction of 0.26 mmol/L and 0.15 mmol/L respectively. Triglyceride levels were significantly increased in the patient group, corresponding to an absolute increase of 0.08 mmol/L. However, HDL cholesterol and leptin levels were not altered in patients v. controls.ConclusionsTotal and LDL cholesterol levels are reduced in FEP, indicating that hypercholesterolaemia in patients with chronic disorder is secondary and potentially modifiable. In contrast, triglycerides are elevated in FEP. Hypertriglyceridaemia is a feature of type 2 diabetes mellitus, therefore this finding adds to the evidence for glucose dysregulation in this cohort. These findings support early intervention targeting nutrition, physical activity and appropriate antipsychotic prescription.
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Affiliation(s)
- Toby Pillinger
- Toby Pillinger, MRCP, Katherine Beck, MRCPsych, Brendon Stubbs, PhD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and South London and Maudsley National Health Service (NHS) Foundation Trust, London; Oliver D. Howes, PhD MRCPsych, Institute of Psychiatry, Psychology and Neuroscience, King's College London, South London and Maudsley NHS Foundation Trust, Medical Research Council London Institute of Medical Sciences, Hammersmith Hospital, and Institute of Clinical Sciences, Faculty of Medicine, Imperial College, London, UK
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Nayerifard R, Bureng MA, Zahiroddin A, Namjoo M, Rajezi S. Comparison of metabolic syndrome prevalence in patients with schizophrenia and bipolar I disorder. Diabetes Metab Syndr 2017; 11 Suppl 1:S411-S416. [PMID: 28927969 DOI: 10.1016/j.dsx.2017.03.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 03/31/2017] [Indexed: 12/26/2022]
Abstract
UNLABELLED Research has shown that the metabolic syndrome is more prevalent among patients with schizophrenia or bipolar I disorder. Given the scarcity of research on the disorders, this paper aims to compare the prevalence of the syndrome among the two groups of patients. METHODS A total of 120 individuals participated in this cross sectional study: 60 patients with schizophrenia (26 males and 34 females) and 60 patients with bipolar I disorder (32 males and 28 females). The psychological disorders were diagnosed by some experienced psychiatrists according to the DSM-V. Furthermore, metabolic syndrome was diagnosed according to ATP III guidelines. RESULTS Metabolic syndrome prevalence among schizophrenic and bipolar I patients was 28 and 36 percent, respectively; the disparity in prevalence is not significant. According to the results, compared to their male counterparts, females were more prone significant to metabolic syndrome. Moreover, diastolic blood pressure was significantly higher among bipolar I patients. On the other hand, schizophrenic males were observed to have higher fasting blood sugar levels in comparison to bipolar I males patients. Age, consumption of second generation antipsychotics or antidepressants, and the duration of the disorder were found to be related to metabolic syndrome. CONCLUSION This study showed that metabolic syndrome is not more prevalent among bipolar I patients, compared to those with schizophrenia. Also, women are more likely to be affected by the syndrome. A number of factors such as age, consumption of medication, and duration of the disorder are associated with the likelihood of the syndrome.
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Affiliation(s)
- Razieh Nayerifard
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Alireza Zahiroddin
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Massood Namjoo
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sepideh Rajezi
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Skibinska M, Kapelski P, Pawlak J, Rajewska-Rager A, Dmitrzak-Weglarz M, Szczepankiewicz A, Czerski P, Twarowska-Hauser J. Glial Cell Line-Derived Neurotrophic Factor (GDNF) serum level in women with schizophrenia and depression, correlation with clinical and metabolic parameters. Psychiatry Res 2017; 256:396-402. [PMID: 28689143 DOI: 10.1016/j.psychres.2017.07.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/14/2017] [Accepted: 07/04/2017] [Indexed: 12/15/2022]
Abstract
AIM Neurotrophic factors have been implicated in neuropsychiatric disorders, including schizophrenia and depression. Glial Cell Line-Derived Neurotrophic Factor (GDNF) promotes development, differentiation, and protection of dopaminergic, serotonergic, GABAergic and noradrenergic neurons as well as glial cells in different brain regions. This study examined serum levels of GDNF in schizophrenia and depression and its correlation with metabolic parameters during 8 weeks of treatment. METHODS Serum GDNF level, fasting serum glucose and lipid profile were measured at baseline and week 8 in 133 women: 55 with schizophrenia, 30 with a first episode depression and 48 healthy controls. The severity of the symptoms was evaluated using Positive and Negative Syndrome Scale (PANSS), 17-item Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory (BDI). RESULTS There was statistically significant higher GDNF level in schizophrenia at baseline when compared with week 8. Correlations of GDNF with PANSS in schizophrenia and cholesterol level in depression have also been detected. CONCLUSIONS To our knowledge, this is the first study which correlates GDNF levels with metabolic parameters. Our results show no differences in GDNF serum level between schizophrenia, a first depressive episode, and healthy controls. GDNF serum level did not correlate with metabolic parameters except for total cholesterol in depression.
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Affiliation(s)
- Maria Skibinska
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland.
| | - Pawel Kapelski
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
| | - Joanna Pawlak
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
| | - Aleksandra Rajewska-Rager
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland; Department of Adult Psychiatry, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Monika Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
| | - Aleksandra Szczepankiewicz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland; Laboratory of Molecular and Cell Biology, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland
| | - Piotr Czerski
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
| | - Joanna Twarowska-Hauser
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland
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Sethi S, Hayashi MA, Sussulini A, Tasic L, Brietzke E. Analytical approaches for lipidomics and its potential applications in neuropsychiatric disorders. World J Biol Psychiatry 2017; 18:506-520. [PMID: 26555297 DOI: 10.3109/15622975.2015.1117656] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES In this review, the authors discuss an overview of lipidomics followed by in-depth discussion of its application to the study of human diseases, including extraction methods of lipids, analytical techniques and clinical research in neuropsychiatric disorders. METHODS Lipidomics is a lipid-targeted metabolomics approach aiming at the comprehensive analysis of lipids in biological systems. Recent technological advancements in mass spectrometry and chromatography have greatly enhanced the development and applications of metabolic profiling of diverse lipids in complex biological samples. RESULTS An effective evaluation of the clinical course of diseases requires the application of very precise diagnostic and assessment approaches as early as possible. In order to achieve this, "omics" strategies offer new opportunities for biomarker identification and/or discovery in complex diseases and may provide pathological pathways understanding for diseases beyond traditional methodologies. CONCLUSIONS This review highlights the importance of lipidomics for the future perspectives as a tool for biomarker identification and discovery and its clinical application.
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Affiliation(s)
- Sumit Sethi
- a Interdisciplinary Laboratory for Clinical Neuroscience (LiNC), Department of Psychiatry , Universidade Federal De São Paulo - UNIFESP , São Paulo , Brazil
| | - Mirian A Hayashi
- a Interdisciplinary Laboratory for Clinical Neuroscience (LiNC), Department of Psychiatry , Universidade Federal De São Paulo - UNIFESP , São Paulo , Brazil
| | - Alessandra Sussulini
- b Department of Analytical Chemistry , Institute of Chemistry, Universidade Estadual De Campinas - UNICAMP , Campinas , SP , Brazil
| | - Ljubica Tasic
- c Department of Organic Chemistry , Institute of Chemistry, Universidade Estadual De Campinas - UNICAMP , Campinas , SP , Brazil
| | - Elisa Brietzke
- a Interdisciplinary Laboratory for Clinical Neuroscience (LiNC), Department of Psychiatry , Universidade Federal De São Paulo - UNIFESP , São Paulo , Brazil
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Chen CC, Hsu LW, Huang KT, Goto S, Chen CL, Nakano T. Overexpression of Insig-2 inhibits atypical antipsychotic-induced adipogenic differentiation and lipid biosynthesis in adipose-derived stem cells. Sci Rep 2017; 7:10901. [PMID: 28883496 PMCID: PMC5589828 DOI: 10.1038/s41598-017-11323-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/22/2017] [Indexed: 01/10/2023] Open
Abstract
Atypical antipsychotics (AAPs) are considered to possess superior efficacy for treating both the positive and negative symptoms of schizophrenia; however, AAP use often causes excessive weight gain and metabolic abnormalities. Recently, several reports have demonstrated that AAPs activate sterol regulatory element-binding protein (SREBP). SREBP, SREBP cleavage-activating protein (SCAP) and insulin-induced gene (Insig) regulate downstream cholesterol and fatty acid biosynthesis. In this study, we explored the effects of clozapine, olanzapine and risperidone on SREBP signaling and downstream lipid biosynthesis genes in the early events of adipogenic differentiation in adipose-derived stem cells (ASCs). After the induction of adipogenic differentiation for 2 days, all AAPs, notably clozapine treatment for 3 and 7 days, enhanced the expression of SREBP-1 and its downstream lipid biosynthesis genes without dexamethasone and insulin supplementation. Simultaneously, protein level of SREBP-1 was significantly enhanced via inhibition of Insig-2 expression. By contrast, SREBP-1 activation was suppressed when Insig-2 expression was upregulated by transfection with Insig-2 plasmid DNA. In summary, our results indicate that AAP treatment, notably clozapine treatment, induces early-stage lipid biosynthesis in ASCs. Such abnormal lipogenesis can be reversed when Insig-2 expression was increased, suggesting that Insig/SCAP/SREBP signaling may be a therapeutic target for AAP-induced weight gain and metabolic abnormalities.
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Affiliation(s)
- Chien-Chih Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan
| | - Li-Wen Hsu
- Liver Transplantation Center and Department of Surgery, Division of Transplant Immunology, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan
| | - Kuang-Tzu Huang
- Liver Transplantation Center and Department of Surgery, Division of Transplant Immunology, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan
| | - Shigeru Goto
- Liver Transplantation Center and Department of Surgery, Division of Transplant Immunology, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan
| | - Chao-Long Chen
- Liver Transplantation Center and Department of Surgery, Division of Transplant Immunology, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan
| | - Toshiaki Nakano
- Liver Transplantation Center and Department of Surgery, Division of Transplant Immunology, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan. .,Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan.
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Monroy-Jaramillo N, Rodríguez-Agudelo Y, Aviña-Cervantes LC, Roberts DL, Velligan DI, Walss-Bass C. Leukocyte telomere length in Hispanic schizophrenia patients under treatment with olanzapine. J Psychiatr Res 2017; 90:26-30. [PMID: 28226264 DOI: 10.1016/j.jpsychires.2017.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 02/06/2017] [Indexed: 11/27/2022]
Abstract
Different lines of evidence indicate that patients with schizophrenia (SZ) exhibit accelerated aging. Leukocyte telomere length (TL), an aging marker, is associated with age-related and chronic pathologies, including schizophrenia. We analyzed leukocyte TL in 170 SZ patients of Hispanic ancestry grouped based on antipsychotic treatment, compared to 126 matched controls. The group under treatment with atypical antipsychotics was further subdivided according to the risk of medication to cause metabolic syndrome (MetS). Our results show significant erosion in the TL of SZ patients under treatment with the atypical antipsychotics clozapine and olanzapine, which cause high-risk for MetS, compared to healthy controls and patients under treatment with medium and low-risk antipsychotics. However, when the analysis was done separately for clozapine and olanzapine, a significant difference remained only for olanzapine. These findings suggest that atypical antipsychotics that cause high-risk for MetS, particularly olanzapine, may modulate leukocyte TL in SZ patients. Future research is required to elucidate if in fact atypical antipsychotics are involved in TL maintenance in SZ subjects and the mechanism by which this occurs.
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Affiliation(s)
- Nancy Monroy-Jaramillo
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Department of Genetics, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez. Insurgentes Sur 3877 Col. La Fama, Tlalpan, C. P. 14269 Mexico city, Mexico.
| | - Yaneth Rodríguez-Agudelo
- Department of Neuropsychology, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez. Insurgentes Sur 3877 Col. La Fama, Tlalpan, C. P. 14269 Mexico city, Mexico.
| | - Luis Carlos Aviña-Cervantes
- Department of Psychiatry, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez. Insurgentes Sur 3877 Col. La Fama, Tlalpan, C. P. 14269 Mexico city, Mexico.
| | - David L Roberts
- Department of Psychiatry, Division of Schizophrenia and Related Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Dawn I Velligan
- Department of Psychiatry, Division of Schizophrenia and Related Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Consuelo Walss-Bass
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
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Hussain T, Margoob MA, Shoib S, Shafat M, Chandel RK. Prevalence of Metabolic Syndrome among Psychiatric Inpatients: A Hospital Based Study from Kashmir. J Clin Diagn Res 2017; 11:VC05-VC08. [PMID: 28764273 DOI: 10.7860/jcdr/2017/25801.10011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/27/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Over the last fifty years there has been dramatic change in the human environment, behaviours and way-of-life. These changes have resulted in escalating rates of metabolic syndrome not only in general population but also among people with mental illness. Various factors, like the lack of exercise, use of psychotropic medications and inadequate medical care leads to the increased risk of metabolic changes among people with mental illness. Hence, there is a greater need to evaluate metabolic syndrome in this population. AIM To find the prevalence of metabolic syndrome among psychiatric inpatients in Tertiary Care Hospital in Kashmir region of North India. MATERIALS AND METHODS It was a cross-sectional study conducted at the Institute of Mental Health and Neurosciences, Kashmir, India. A total of 213 in-patients with a primary psychiatric diagnosis as per The International Classification of Diseases, Tenth Revision (ICD 10) Classification of Mental and Behavioural Disorders criteria were evaluated for the presence of metabolic syndrome. A modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criterion for the diagnosis of metabolic syndrome was used. All the intergroup comparisons for parametric data were done by Student's t-test, whereas non-parametric data were analysed by Chi-square tests. A p-value <0.05 was considered statistically significant. RESULTS The overall prevalence of metabolic syndrome was 34.74%. The prevalence was higher in females (43.3%) than males (28.5%) (p<0.05) and it increased with age, with the highest prevalence in the age group >50 years (p<0.05). Among the diagnostic subgroups, the prevalence was highest among patients with unipolar depression (45.0%), while it was lesser in patients with bipolar disorders (37.88%) and psychotic disorders (30.95%). Prevalence of metabolic syndrome was significantly higher (63.64%) among patients taking second generation antipsychotics (p<0.05). CONCLUSION Our study shows that metabolic syndrome is highly prevalent among psychiatric inpatients and needs to be addressed to prevent the risk for cardiovascular diseases.
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Affiliation(s)
- Tajamul Hussain
- Senior Resident, Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Mushtaq Ahmad Margoob
- Professor and Ex-Head, Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Sheikh Shoib
- Senior Resident, Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Mahak Shafat
- Resident, Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Rajesh Kumar Chandel
- Consultant Psychiatrist, Department of Health and Medical Education, Jammu and Kashmir, India
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Malhotra N, Kulhara P, Chakrabarti S, Grover S. Lifestyle related factors & impact of metabolic syndrome on quality of life, level of functioning & self-esteem in patients with bipolar disorder & schizophrenia. Indian J Med Res 2017; 143:434-42. [PMID: 27377499 PMCID: PMC4928549 DOI: 10.4103/0971-5916.184284] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background & objectives: Though studies have reported high prevalence rates of metabolic syndrome among patients with bipolar disorder (BPAD) and schizophrenia, there is lack of data on the impact of the same on the patients’ life. This study was aimed to assess the lifestyle related factors associated with metabolic syndrome (MetS) and to study the impact of MetS on functioning and quality of life (QOL) in patients with BPAD and schizophrenia. Methods: A total of 102 patients with BPAD and 72 patients with schizophrenia attending the output unit of a tertiary care hospital in north India were evaluated for MetS. These patients were assessed on Health Promoting Lifestyle Profile scale II (HPLP II), World Health Organization QOL -Bref Version (WHOQOL-Bref), Impact of Weight on Quality of Life- Lite version (IWOQOL -Lite), Body weight, Image and Self-esteem Evaluation questionnaire (BWISE), Obesity-related Problem scale (OP scale) and Global Assessment of Functioning (GAF) scale. Results: MetS was associated with lower scores on domains of health responsibility and nutrition habit domain on HPLP-II scale in both groups, and additionally on physical activity and stress management domain in BPAD group. On WHOQOL-Bref, MetS was associated with lower scores on the domains of physical and psychological health in both groups. On IWQOL–Lite, scores on personal distress and self esteem domains were higher in those with obesity in both groups and also on physical activity domain in schizophrenia group. Those with MetS had lower level of functioning as measured by GAF in schizophrenia group. Fulfillment of higher number of criteria of MetS correlated with poorer quality of life and higher problems in both groups. Interpretation & conclusions: Many modifiable lifestyle factors increase the risk of MetS. MetS was found to be associated with poorer QOL in patients with BPAD and schizophrenia; in addition, obesity led to poor self-esteem and excessive personal distress.
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Affiliation(s)
- Nidhi Malhotra
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Parmanand Kulhara
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Bruno A, Pandolfo G, Crucitti M, Cacciola M, Santoro V, Spina E, Zoccali RA, Muscatello MRA. Low-Dose of Bergamot-Derived Polyphenolic Fraction (BPF) Did Not Improve Metabolic Parameters in Second Generation Antipsychotics-Treated Patients: Results from a 60-days Open-Label Study. Front Pharmacol 2017; 8:197. [PMID: 28443024 PMCID: PMC5387046 DOI: 10.3389/fphar.2017.00197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/27/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives: The nutraceutical approach to the management of metabolic syndrome (MetS) might be a promising strategy in the prevention of cardio-metabolic risk. Low-dose bergamot-derived polyphenolic fraction (BPF) has been proven effective in patients with MetS, as demonstrated by a concomitant improvement in lipemic and glycemic profiles. The present study was aimed to further explore, in a sample of subjects receiving second generation antipsychotics (SGAs), the effects on body weight and metabolic parameters of a low dose of BPF (500 mg/day) administered for 60 days. Methods: Twenty-eight outpatients treated with SGAs assumed BPF at single daily dose of 500 mg/day for 60 days. Body weight, BMI, fasting levels of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides were determined; moreover, Brief Psychiatric Rating Scale (BPRS) was administered. Results: Low-dose BPF administration did not change clinical and metabolic parameters, as well as clinical symptoms in the study sample. At the end of the trial, among completers (n = 24) only nine patients (37.5%) reached an LDL reduction >0 but <50%. Conclusions: Our results demonstrate that patients treated with SGAs may need higher BPF doses for obtaining the positive effects on body weight and metabolic parameters previously found in the general population at lower doses.
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Affiliation(s)
- Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of MessinaMessina, Italy
| | - Gianluca Pandolfo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of MessinaMessina, Italy
| | - Manuela Crucitti
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of MessinaMessina, Italy
| | - Massimo Cacciola
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of MessinaMessina, Italy
| | - Vincenza Santoro
- Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Edoardo Spina
- Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy
| | - Rocco A Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of MessinaMessina, Italy
| | - Maria R A Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of MessinaMessina, Italy
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Grover S, Chakrabarti S, Kulhara P, Avasthi A. Clinical Practice Guidelines for Management of Schizophrenia. Indian J Psychiatry 2017; 59:S19-S33. [PMID: 28216783 PMCID: PMC5310098 DOI: 10.4103/0019-5545.196972] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
| | | | | | - Ajit Avasthi
- Department of Psychiatry, PGIMER, Chandigarh, India
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Medeiros-Ferreira L, Navarro-Pastor JB, Zúñiga-Lagares A, Romaní R, Muray E, Obiols JE. Perceived needs and health-related quality of life in people with schizophrenia and metabolic syndrome: a "real-world" study. BMC Psychiatry 2016; 16:414. [PMID: 27871263 PMCID: PMC5117524 DOI: 10.1186/s12888-016-1005-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 08/16/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The complexity of schizophrenia lies in the combination of psychiatric, somatic and social needs requiring care. The aim of the study was to compare perceived needs between groups with absence/presence of metabolic syndrome (MetS) and to analyze the relationship between needs, health-related quality of life (HRQoL) and MetS in people with schizophrenia or schizoaffective disorder. METHODS A "real-world" cross-sectional study was set up with a comprehensive framework including the following, needs for care (Camberwell Assessment of Need Interview [CAN]), HRQoL (Euro Qol-5D Questionnaire), sociodemographic data, lifestyle habits, psychopathology (Positive And Negative Syndrome Scale [PANSS]), global functioning (Global Assessment of Functioning Scale [GAF]), anthropometric measurements and blood test results were assessed for an outpatient sample (n = 60). RESULTS The mean number of needs (given by CAN) was identified for both groups. Patients with MetS rated a higher number of needs compared to the group without this condition. Mobility problems (given by EQ-5D) were negatively associated with the number of total and unmet needs. For participants with MetS, HRQoL was related to the number of needs and unmet needs. For people with MetS, positive symptomatology score (given by PANSS) was related to the number of needs and met needs and general symptomatology was associated with total, met and unmet needs. For individuals without MetS, the global functioning score (given by GAF) was significantly inversely related with total, met and unmet needs. CONCLUSIONS Needs and HRQoL, as well as general symptomatology, were related only in patients with MetS. This has implications for treatment planning at the individual and organizational levels. An analysis of both physical and mental needs could provide a starting point for the extension of facilities in the health care system in order to reach the goal of improving quality of life.
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Affiliation(s)
- Leticia Medeiros-Ferreira
- Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona/Nou Barris Nord Mental Health Center, Paseo Valldaura 214- bajos, 08042, Barcelona, Spain. .,Nou Barris Nord Mental Health Center, Paseo Valldaura 214- bajos, 08042, Barcelona, Spain.
| | - José Blas Navarro-Pastor
- Department of Psychobiology and Methodology of Health Sciences, Faculty of Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Zúñiga-Lagares
- Nou Barris Nord Mental Health Center, Paseo Valldaura 214- bajos, 08042 Barcelona, Spain
| | - Rosanna Romaní
- Nou Barris Nord Mental Health Center, Paseo Valldaura 214- bajos, 08042 Barcelona, Spain
| | - Elisenda Muray
- Nou Barris Nord Mental Health Center, Paseo Valldaura 214- bajos, 08042 Barcelona, Spain
| | - Jordi E. Obiols
- Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona/Nou Barris Nord Mental Health Center, Paseo Valldaura 214- bajos, 08042 Barcelona, Spain
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Castillo RI, Rojo LE, Henriquez-Henriquez M, Silva H, Maturana A, Villar MJ, Fuentes M, Gaspar PA. From Molecules to the Clinic: Linking Schizophrenia and Metabolic Syndrome through Sphingolipids Metabolism. Front Neurosci 2016; 10:488. [PMID: 27877101 PMCID: PMC5100552 DOI: 10.3389/fnins.2016.00488] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 10/12/2016] [Indexed: 12/12/2022] Open
Abstract
Metabolic syndrome (MS) is a prevalent and severe comorbidity observed in schizophrenia (SZ). The exact nature of this association is controversial and very often accredited to the effects of psychotropic medications and disease-induced life-style modifications, such as inactive lifestyle, poor dietary choices, and smoking. However, drug therapy and disease-induced lifestyle factors are likely not the only factors contributing to the observed converging nature of these conditions, since an increased prevalence of MS is also observed in first episode and drug-naïve psychosis populations. MS and SZ share common intrinsic susceptibility factors and etiopathogenic mechanisms, which may change the way we approach clinical management of SZ patients. Among the most relevant common pathogenic pathways of SZ and MS are alterations in the sphingolipids (SLs) metabolism and SLs homeostasis. SLs have important structural functions as they participate in the formation of membrane “lipid rafts.” SLs also play physiological roles in cell differentiation, proliferation, and inflammatory processes, which might be part of MS/SZ common pathophysiological processes. In this article we review a plausible mechanism to explain the link between MS and SZ through a disruption in SL homeostasis. Additionally, we provide insights on how this hypothesis can lead to the developing of new diagnostic/therapeutic technologies for SZ patients.
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Affiliation(s)
- Rolando I Castillo
- Translational Psychiatry Laboratory, Clínica Psiquiátrica Universitaria, Hospital Clínico Universidad de Chile Santiago, Chile
| | - Leonel E Rojo
- Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile Santiago, Chile
| | - Marcela Henriquez-Henriquez
- Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica de ChileSantiago, Chile; Department of Pediatrics, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia UniversityNew York, NY, USA; Department of Pathology and Cell Biology, Columbia UniversityNew York, NY, USA
| | - Hernán Silva
- Translational Psychiatry Laboratory, Clínica Psiquiátrica Universitaria, Hospital Clínico Universidad de ChileSantiago, Chile; Facultad de Medicina, Biomedical Neuroscience Institute, Universidad de ChileSantiago, Chile
| | - Alejandro Maturana
- Translational Psychiatry Laboratory, Clínica Psiquiátrica Universitaria, Hospital Clínico Universidad de Chile Santiago, Chile
| | - María J Villar
- Translational Psychiatry Laboratory, Clínica Psiquiátrica Universitaria, Hospital Clínico Universidad de Chile Santiago, Chile
| | - Manuel Fuentes
- Departamento de Psiquiatría, Clínica Alemana Santiago, Chile
| | - Pablo A Gaspar
- Translational Psychiatry Laboratory, Clínica Psiquiátrica Universitaria, Hospital Clínico Universidad de ChileSantiago, Chile; Facultad de Medicina, Biomedical Neuroscience Institute, Universidad de ChileSantiago, Chile; Departamento de Psiquiatría, Clínica AlemanaSantiago, Chile
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Bruno A, Pandolfo G, Crucitti M, Maisano A, Zoccali RA, Muscatello MRA. Metabolic outcomes of bergamot polyphenolic fraction administration in patients treated with second-generation antipsychotics: a pilot study. J Nutr Biochem 2016; 40:32-35. [PMID: 27846426 DOI: 10.1016/j.jnutbio.2016.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/13/2016] [Accepted: 10/17/2016] [Indexed: 11/25/2022]
Abstract
Second-generation antipsychotics (SGAs) are notoriously associated with a marked increase in body weight and with a wide range of metabolic adverse effects, and their chronic use is related with an increased risk for the development of metabolic syndrome (MS). Different adjunctive treatments have been proposed to reduce SGAs-induced weight gain and/or metabolic abnormalities with inconsistent or too limited evidence to support their regular clinical use, thus suggesting the need to find new possible treatments. Bergamot polyphenolic fraction (BPF) has been proven effective in patients with MS, as demonstrated by a concomitant improvement in lipemic and glycemic profiles. The present study was aimed to explore the efficacy and safety of BPF treatment on metabolic parameters in a sample of subjects receiving atypical antipsychotics. Fifteen outpatients treated with SGAs assumed BPF at the oral daily dose of 1000 mg/day for 30 days. Fasting levels of glucose, glycated hemoglobin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides were determined. BPF administration resulted in a statistically significant reduction of body weight (P=.004) and in a trend for body mass index decrease (P=.005). No significant differences in other and metabolic parameters were observed. Our findings suggest that BPF, at the daily dose of 1000 mg for 30 days, could be an effective and safe agent to prevent weight gain associated with atypical antipsychotic use. However, further clinical trials with adequately powered and well-designed methodology are needed to better explore the BPF effectiveness on the SGAs-induced weight gain and metabolic side effects.
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Affiliation(s)
- Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy.
| | - Gianluca Pandolfo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Manuela Crucitti
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Antonino Maisano
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Rocco A Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 1, Messina, Italy
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Grover S, Hazari N, Chakrabarti S, Avasthi A. Metabolic Disturbances, Side Effect Profile and Effectiveness of Clozapine in Adolescents. Indian J Psychol Med 2016; 38:224-33. [PMID: 27335518 PMCID: PMC4904759 DOI: 10.4103/0253-7176.183091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Data on effect of clozapine on metabolic syndrome in adolescent patients with psychosis are limited. This study aimed to evaluate the prevalence and incidence of metabolic syndrome in children and adolescents with psychotic disorders prior to clozapine and while receiving clozapine. Secondary aims were to study the effectiveness and side effect profile of clozapine. MATERIALS AND METHODS Thirteen child and adolescent patients were evaluated at baseline, 3 months, and a follow-up beyond 6 months. Assessments were made for metabolic profile, effectiveness by positive and negative syndrome scale (PANSS), and side effects. RESULTS Prior to starting of clozapine, the prevalence of metabolic syndrome was 23%. After 3 months on clozapine, 38.5% (5/13) patients fulfilled criteria of metabolic syndrome and further on follow-up beyond 6 months (with last observation carried forward) 46.2% (6/13) had developed metabolic syndrome. There was a significant reduction in PANSS scores at 3 months and follow-up more so in those who developed metabolic syndrome at 3 months. Among the other side effects, hypersalivation was the most common side effect (100%) followed by sedation (69%). CONCLUSION Half the prevalence of metabolic syndrome in adolescents on clozapine can be attributed to other factors prior to starting of clozapine, and another half can be attributed to clozapine. Clozapine is effective in an adolescent population.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nandita Hazari
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Subho Chakrabarti
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Grover S, Balachander S, Chakarabarti S, Avasthi A. Prescription practices and attitude of psychiatrists towards clozapine: A survey of psychiatrists from India. Asian J Psychiatr 2015; 18:57-65. [PMID: 26498722 DOI: 10.1016/j.ajp.2015.09.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 09/20/2015] [Accepted: 09/28/2015] [Indexed: 01/17/2023]
Abstract
AIM To assess the attitude of psychiatrists towards clozapine and also to evaluate the prescription practices of psychiatrists for clozapine. METHODOLOGY An email survey was sent to 3381 psychiatrists from India, of whom 548 (16.2%) responded. RESULTS Mean number of years in clinical practice was 12.59 (SD-10.1) for participating psychiatrists. Majority of the participants rated their knowledge about clozapine to be good (61.5%)/very good (34.5%). The primary indication for use of clozapine for almost all the participants was treatment resistance and most of the psychiatrists initiated clozapine either in the dose of 25mg OD (44.3%) or 12.5mg OD (37%). Half (51.8%) of the psychiatrists preferred to use clozapine as BD dosing schedule, and median doses required to stabilize the patients ranged from 137.5 to 400mg/day. Once the clozapine dose had been stabilized, about half (51%) of the psychiatrists advised blood monitoring at monthly intervals. Almost all psychiatrists rated effectiveness of clozapine to be better than other antipsychotics. In terms of tolerability, 45.3% of the psychiatrists rated it as 'same as other antipsychotics' and 15.9% rated it as better than other antipsychotics. Most common patient and therapist related factors associated with reluctance to start clozapine were history of poor medication compliance and need for monitoring, respectively. Upon reviewing the prescription of other psychiatrists, participating psychiatrists reported that in about 28.46% of patients clozapine was not prescribed though indicated. CONCLUSIONS This survey suggests that clozapine is underused in India, although psychiatrists have adequate knowledge about the drug but many psychiatrists have negative attitude towards clozapine.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Srinivas Balachander
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Subho Chakarabarti
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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de Silva VA, Dayabandara M, Wijesundara H, Henegama T, Gunewardena H, Suraweera C, Hanwella R. Metformin for treatment of antipsychotic-induced weight gain in a South Asian population with schizophrenia or schizoaffective disorder: A double blind, randomized, placebo controlled study. J Psychopharmacol 2015; 29:1255-61. [PMID: 26510448 DOI: 10.1177/0269881115613519] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Antipsychotic-induced weight gain causes serious health problems. We investigated the efficacy and safety of metformin in treating antipsychotic-induced weight gain in South Asian patients. METHODS Sixty six adult patients with schizophrenia or schizoaffective disorder treated, with atypical antipsychotics, and who had increased by more than 10% their pre treatment body weight, were randomly assigned to receive metformin or placebo in a double-blind study. Patients received usual treatment and metformin 500 mg or placebo twice daily for 24 weeks. The primary outcome measure was change in body weight from baseline to week 24. Linear mixed models were used in the analysis. RESULTS Mean change in body weight in the metformin group was -1.56 kg (95% CI=-3.06 to -0.05) and 1.0 kg (95% CI=0.03-1.97) in the placebo group. Between-group difference was 2.56 kg. At 24 weeks the between-group difference showed significant time-by-treatment interaction (F=3.23, p=0.004). Between-group difference in BMI showed significant time-by-treatment interaction (F=3.41 p=0.03). There was no significant difference in waist-hip ratio or fasting blood sugar. CONCLUSIONS Metformin is effective in reducing weight in South Asian patients with schizophrenia or schizoaffective disorder who had increased their body by more than 10% after treatment with atypical antipsychotics.
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Affiliation(s)
- Varuni A de Silva
- Department of Psychological Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Hiranya Wijesundara
- Senior Registrar in Psychiatry, University Psychiatry Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Thushani Henegama
- Senior Registrar in Psychiatry, University Psychiatry Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Heshan Gunewardena
- Senior Registrar in Psychiatry, University Psychiatry Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Chathurie Suraweera
- Senior Registrar in Psychiatry, University Psychiatry Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Raveen Hanwella
- Department of Psychological Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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